Crystal Springs Baptist Church VBS Registration 📖✨

Crystal Springs Baptist Church VBS Registration 📖✨

Please provide parent/guardian contact details and information for each registered child. Review and agree to the necessary permissions and acknowledgments. Anyone registering, that wants their child or children to have a t-shirt, needs to submit this form before Sunday, May 24, 2026.
Parent/Guardian Contact Information
Primary Parent/Guardian Full Name

First NameMiddle NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Preferred Contact Method
Emergency Contact Name

First NameMiddle NameLast Name
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name

First NameMiddle NameLast Name
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Family and Church Information
Number of Children
Home Church Name
Is This Your First Time Visiting?
Child Registration
Child 1 Full Name

First NameMiddle NameLast Name
Child 1 Date of Birth

MonthDayYear
Date
Child 1 Age
Child 1 Grade Completed
Child 1 Gender
Child 1 Allergies or Medical Conditions
Child 1 Dietary Restrictions
Child 1 Special Needs or Accommodations
Child 1 T-Shirt Size
Child 2

Child 2 information
Child 2 Full Name

First NameMiddle NameLast Name
Child 2 Date of Birth

MonthDayYear
Date
Child 2 Age
Child 2 Grade Completed
Child 2 Gender
Child 2 Allergies or Medical Conditions
Child 2 Dietary Restrictions
Child 2 Special Needs or Accommodations
Child 2 T-Shirt Size
Child 3

Child 3 information
Child 3 Full Name

First NameMiddle NameLast Name
Child 3 Date of Birth

MonthDayYear
Date
Child 3 Age
Child 3 Grade Completed
Child 3 Gender
Child 3 Allergies or Medical Conditions
Child 3 Dietary Restrictions
Child 3 Special Needs or Accommodations
Child 3 T-Shirt Size
Child 4

Child 4 information
Child 4 Full Name

First NameMiddle NameLast Name
Child 4 Date of Birth

MonthDayYear
Date
Child 4 Age
Child 4 Grade Completed
Child 4 Gender
Child 4 Allergies or Medical Conditions
Child 4 Dietary Restrictions
Child 4 Special Needs or Accommodations
Child 4 T-Shirt Size
Child 5

Child 5 information
Child 5 Full Name

First NameMiddle NameLast Name
Child 5 Date of Birth

MonthDayYear
Date
Child 5 Age
Child 5 Grade Completed
Child 5 Gender
Child 5 Allergies or Medical Conditions
Child 5 Dietary Restrictions
Child 5 Special Needs or Accommodations
Child 5 T-Shirt Size
Participation Permissions and Acknowledgments
Consent for Child to Participate in VBS Activities
Emergency Medical Treatment Authorization
Liability Acknowledgment
Photo, Video, and Media Release
Pickup and Release Authorization
Approved Pickup Name
Approved Pickup Name
Approved Pickup Name
Approved Pickup Name
Signature
Parent/Guardian Certification, Authorization, and Consent

I hereby certify that all information provided on this registration form is complete, true, and correct to the best of my knowledge. I affirm that I have read and fully understand all sections of this form, including all permissions, authorizations, waivers, and releases. By typing my name below, I acknowledge that I have indicated my decisions where required and voluntarily grant or deny such permissions as marked.

I understand and agree that my typed name constitutes my legally binding signature and confirms my consent to all terms outlined in this document.
Printed Name

First NameLast Name
Date

MonthDayYear
Date
Should be Empty:

Crystal Springs Baptist Church VBS Registration 📖✨

Parent/Guardian Contact Information

Family and Church Information

Child Registration

Child 2

Child 3

Child 4

Child 5

Participation Permissions and Acknowledgments

Signature