Bible Beach Club VBS 2024

Bible Beach Club VBS 2024

Hosted by Crosspoint Christian Church
July 29th-31st, 2-4 PM

1710 West Dallas Ave, Selma AL 36701
Parent/Caregiver Full Name*

First NameLast Name
E-mail
example@example.com
Phone Number*
Childs Full Name*

First NameLast Name
Child's Age*
Child's Grade*
Snack will be provided. Please list if they have any allergies. IF YOUR CHILD DOES NOT HAVE ANY ALLERGIES PLEASE ENTER "NONE"*
Please list any medical condition(s) or any other information we should be aware of. IF YOUR CHILD DOES NOT HAVE ANY APPLICABLE CONDITIONS, PLEASE ENTER "NONE".*
All parents are welcomed to attend VBS.

Please list an emergency contact that is not yourself. This person will only be contacted if we are unable to reach you in case of an emergency. If they are to pick up your child, they must show a photo ID to verify their name matches the name on form.
Alternate Emergency Contact - Full Name*

First NameLast Name
Phone Number*
DISCLAIMER CLAUSE: All members, directors, officers, employees, agents, representatives and/or volunteers involved in Crosspoint VBS (hereafter “VBS”) is/are not responsible for any injury, loss or damage of any kind sustained by any person while participating in the VBS, including injury, loss or damage which might be caused by the negligence of VBS.
I acknowledge I have read and executed this agreement voluntarily, and it is to be binding upon myself, and any heirs, executors, administrators and representatives.*

I have read the above disclaimer and agree.
Signature *

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Bible Beach Club VBS 2024

July 29th-31st, 2-4 PM