"CnC Surf" VBS Registration
June 3-7 | 7-9 pm | Ages 4-12
Child's Full Name
*
First Name
Last Name
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Child's Age
*
Grade Just Completed
*
Parent or Guardian
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Would you like to receive emails from our church about events and what's happening at CWC?
*
Yes
No
Emergency Contact
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Relation to child
*
Please list any allergies or health issues:
Friend(s) that your child would like to be grouped with:
My Products
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VBS T-Shirt
T-shirts are OPTIONAL. If you would like to purchase one, please select the box to the left, choose your child's size below, and make payment.
$
10.00
Size
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
ACH Bank Transfer
Submit
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