CCF Vacation Bible School Registration Form

Vacation Bible School Registration Form

Carlisle Christian Fellowship: VBS 2024 - The Great Adventure
Institution Name
STUDENT INFORMATION
Name

First NameLast Name
Birth Date *

MonthDayYear
Date
Gender
Grade completed: *
Home Church (if any)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Siblings to also be Enrolled in VBS (please list name, gender & age): *
EMERGENCY CONTACTS
Please list the first and last names and phone numbers off ALL adults who are allowed to pick up this child. The child will only be released to these people.
Primary Guardian*

First NameLast Name
Relationship to child*
Phone Number*
Format: (000) 000-0000.
Alternate Guardian #1*

First NameLast Name
Relationship to child*
Phone Number*
Format: (000) 000-0000.
Medical Information
Please list all allergies -- or type "none" if there are none*
Does your child carry an epi-pen? (please note: if yes, it is the responsibilty of the child's guardian to ensure the child has the epi-pen at every drop off and pick up)*

YesNo
Please list all medical concerns -- or type "none" if there are none*
Additional Information
VBS photos/videos are taken for promotional purposes related to Carlisle Christian Fellowship. These pictures appear in various media outlets such as our Facebook page and webpage. We will never reference your child by name or provide specific information on your child. Do you allow your child to be included in these photos/videos?*

YesNo
The submittal of this VBS electronic registration confirms that I understand all reasonable safety precautions will be taken at all times during the VBS event to protect my child(children) during VBS. I understand the possibility of unforeseen hazards and the inherent possibility of injury. I understand that in the event medical intervention is needed for this child, an attempt will be made to immediately contact the persons listed on this form. In the event that I cannot be reached in an emergency, I hereby give my permission for Carlisle Christian Fellowship to request emergency services and/or for a church representative to transport the child to a medical emergency or urgent care facility for treatment. I agree to hold Carlisle Christian Fellowship, its leaders, employees, and volunteers harmless from any damages, losses, diseases, injuries incurred by my child's participation in VBS.*

YesNo
By submitting this form, I ackowledge I have read and understand the above information.
Signature
Should be Empty:

Vacation Bible School Registration Form

Medical Information

Additional Information