VBS 2024- Power Up

Child's Information

Each child must be registered individually.
VBS is for rising K-6th graders.

Child's Name

What grade is your child entering this fall?

Kindergarden 1st grade 2nd grade 3rd grade 4th grade 5th grade 6th grade

Please list any medicinal or food allergies your child has below (there is food provided each night):

Parent Information

Parent's Name

Alternate Parent Name

This address will receive a confirmation email

Phone

Alternate Phone Number

Address

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 my child as necessary. I do not hold Crossroad BC, its staff or approved workers responsible for any injury that should occur. (The CBC staff or approved workers will notify you immediately of any such occurrence.) I also give permission for photos of my child to be taken during this event and used for promotional purposes

Legal Disclaimer: COVID-19 is highly contagious and is known to spread mainly from person-to-person contact. By attending Crossroads, you agree to abide by the procedures established by the church to protect attendees and staff, and you voluntarily assume the risk that you and/or your family may be exposed to or infected by COVID-19 either at the church, in the church worship service, or in the nursery or Sunday School. You agree to assume all the risks of attendance and participation for you and your family, and you waive any liability against the church and any other parties.

Signed

Description

Wednesday, Thursday & Friday, June 12-14 from 6:30pm-8:30pm

Please fill out this form and click submit.

"Power Up" VBS 2024 is open to kids that are entering Kindergarten-6th grade this upcoming Fall.

For any questions regarding this form or this year's VBS, please contact John Hash by calling the church office @ 540-886-8914 or by emailing him at brojohnhash@gmail.com.

VBS 2024- Power Up

Description

Please Fix the Following