What We Believe
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2019 VBS Pre-Registration (K-5th grade)
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Parent/Guardin First & Last Name:
Emergency Contact #:
Child 1 name, DOB & Grade
Child 2 name, DOB & Grade
Child 3 name, DOB & Grade
Child 4 name, DOB & Grade
Child 5 name, DOB & Grade
My Child/ren will participate Friday Night: 6PM-8PM
My Child/ren will participate Saturday: 10AM-1PM
My Child/ren will participate Sunday: 10AM-Noon
I GIVE MY CONSENT FOR MY SON/DAUGHTER TO PARTICIPATE IN ROAR VBS WITH CROSSPOINT FELLOWSHIP. WHEN IT IS DEEMED NECESSARY FOR MY SON/DAUGHTER’S HEALTH, THE STAFF MAY HAVE MY SON/DAUGHTER HOSPITALIZED OR USE OUTSIDE MEDICAL, SURGICAL, OR DENTAL AID, IN
ANY MEDICAL INFORMATION WE SHOULD BE AWARE OF?
I herby agree that my data entered in the contact form will be stored electronically, and will be processed and used for the purpose of establishing contact. I am aware that I can revoke my consent at any time.
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