Join our group of adventurers on a 5 day trek through the Gospel of Mark. Get your child's ticket to adventure by registering for VBS today!
register
 
Child's Name: *

Please submit a separate form per child attending.
 
Child's Age on July 17: *

 
Child's School and Grade (in the fall): *

 
Address: *

 
Parent/Guardian Name(s): *

 
Parent/Guardian Contact Phone: *

 
Additional Parent/Guardian Contact Phone:

 
Pediatrician Name and Phone: *

 
Emergency Contact Name and Phone:

Must have photo ID to pick up.
 
If someone other than you has permission to pick your child up, please provide their name and phone:

Photo ID will be required to pick up.
 
Please describe any medical conditions or allergies, as well as any medications the child is taking:

 
Please provide any other information about the child that might help us better care for him/her, including whether they have a friend also in attendance:

 
Do you give your permission for CPC to share photos of your child on our website and/or Facebook page? *

     
 
By registering your child for VBS at CPC, you agree to the following: *

I give permission for my son/daughter to take part in Vacation Bible School at Covenant Presbyterian Church. I understand that leaders will take reasonable care during the event, but I acknowledge the possibility that my child, for a short time, may be out of sight of a leader during the club time. I understand that personal accident insurance is my responsibility and agree that I will not hold CPC liable for any injury. I give my permission for emergency medical treatment to be carried out in the event that I cannot be contacted.
     
We can't wait to discover the epic truth of Jesus with you! See you July 17!
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