VBS Registration 2019

July 15-19 | This year’s Vacation Bible School will be Monday, July 15th through Friday, July 19th from 9 am - noon each day.
VBS is for children who will be four years of age as of August 1st and going up through those who have just completed the 5th grade.

Parent/Guardian

Relationship

Address

Phone

This address will receive a confirmation email

Home Church

Please select one option.

Crossway Chapel Do not currently attend church Other

Child #1 Name

Date of Birth

Gender

Please select one option.

Male Female

Allergies/Notes

The rest of the fields are for parents/guardians registering more than 1 child. If you are only registering 1 child, please leave the rest of these sections blank and scroll down to the "Authorized Pick-Up section! You can leave any of these sections blank if they do not apply to the number of children you are registering.

Child #2 Name

Date of Birth (Child #2)

Gender (Child #2)

Please select one option.

Male Female

Allergies/Notes (Child #2)

Child #3 Name

Date of Birth (Child #3)

Gender

Please select one option.

Male Female

Allergies/Notes

Child #4 Name

Date of Birth (Child #4)

Gender (Child #4)

Please select one option.

Male Female

Allergies/Notes

Authorized for Pick-Up

For purposes of security, we will only release children to people who are preauthorized to pick up your children. Please enter below any people other than yourself who may pick up your children during VBS (if you need to make last-minute adjustments you can do so at the registration table).

Name (must match photo ID)

Payment

Please pay for the appropriate # of children that you are registering for. If you are registering for more than 4 children, please submit the registration form again, as 4 is the limit.

1 child ($10.00) 2 children ($20) 3 children ($30) 4 children ($40)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

July 15-19

This year’s Vacation Bible School will be Monday, July 15th through Friday, July 19th from 9 am - noon each day.
VBS is for children who will be four years of age as of August 1st and going up through those who have just completed the 5th grade.

VBS Registration 2019

Description

Please Fix the Following