QCYC Registration Form

Please fill out this form and click submit. You may pay the first installment when you register, or see Bro. Levi Smith to make payments throughout the year.
 
 
Please select one option.
 
 
 
 
 
 
 
 
 
 
 
I hereby give consent for my child to go on this trip with Crossroads Baptist Church and its approved workers. In case of emergency, I hereby grant my permission to have the approved workers from Crossroads BC authorize medical attention by a physician or hospitalization of teen as necessary. I do not hold Crossroads BC, its staff or approved workers responsible for any injury, no matter the severity, that should occur. (The CBC staff or approved workers will notify you immediately of any such occurrence).
Please select all that apply.
 
 
 
 
 
 

Description

Please fill out this form and click submit. You may pay the first installment when you register, or see Bro. Levi Smith to make payments throughout the year.