CBC Preschool
Thursday, March 28, 2024
 
2014 VBS Registration
(fill in every field)
Note:  As soon as we receive your registration, we will send a confirmation email to the address below.  If you have not received a confirmation email within 2 business days (Monday -Thursday), please contact the church office.
Child's Name:                         
Parent/Guardian Name:           
Address:                               
Phone Numbers:
     Home:                              
     Work:                               
     Cell:                                 
Email Address:                       
Birthday:                                
Last Grade Completed:            
 
Medical Information
 
     Medical Info./Conditions (include allergies, etc.)
                                 
     Emergency Contacts (if different than above)
          Name:                         
          Phone:                        
          Relationship to child:    
 
Dismissal Information:
     List Names of those approved to pick up your child (other than the above):
          Person 1:
          Person 2:
          Person 3:
 
Church your family attends:    
 
If invited to attend by
someone at CBC, who:           
 
Child's T-Shirt Size:
     Youth X Small
     Youth Small
     Youth Medium
     Youth Large
     Adult Medium
     Adult Large
     Adult X Large
 
We will be taking pictures & video throughout the week. May we use your child's photo?
     Yes
     No
 
                  
 
 
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