Register for VBS

Family Information

Address

Primary Phone

Alternate Phone

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

Student Information

Gender

Birth Date

Age Group

Food Allergies

Details

Medical Concerns

Details

Media I give Crossroads Bible Church permission to record sounds, images or video of my child while attending this VBS program. I also give permission for Crossroads Bible Church at its sole discretion, to use these sounds, images, or videos in publications (including print, websites and social media platforms) owned by Crossroads Bible Church.

I have more students to register