Pumpkinfest Registration 2026

1

Student Name* This field is required.

First Name

Last Name

2

Parent/Guardian Name* This field is required.

First Name

Last Name

3

Parent/Guardian Email* This field is required.

example@example.com

4

Parent/Guardian Phone Number* This field is required.

Area Code

Phone Number

5

Secondary Emergency Contact* This field is required.

6

Emergency Contact Phone Number* This field is required.

Area Code

Phone Number

7

What is your student's medical card number?* This field is required.

8

Does your student have any medical conditions or allergies?* This field is required.

9

I allow my child to have their photo/video taken during the event and shared for non-commercial purposes (including, but not limited to: Oasis Youth's social media pages, CFBC website, and/or in a slideshow or video during a Sunday church service)* This field is required.

YESNO

10

As the parent/guardian of the above-mentioned student, I release Courtenay Fellowship Baptist Church, and its leaders, directors, staff and volunteers from all claims resulting from illness, injuries or other damages to property or persons, which may be sustained by our child during their participation at Coastal Black's Pumpkinfest. In the event of illness or injury, we hereby authorize leaders of the church to obtain appropriate medical assistance and treatment for the above child.* This field is required.