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VBS Registration 2024
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REGISTER FOR SCUBA VBS TODAY!
COMPLETE THE FORM BELOW.
Child Information:
First Name:
Last Name:
Gender:
Male
Female
Age:
Grade Completed '23-'24:
Name of parent(s) or guardian(s):
Address 1:
Address 2:
County:
City:
State:
Zip/Postal Code:
Phone Number:
Email Address:
Name of home church:
Please list any allergies, medical conditions or special needs:
Names of people who can pick this child up:
Emergency Contact Information
Name:
Phone Number:
Relationship:
Photo Concent:
I release Cornerstone to use photos of my child at VBS in promotional material on our church website, app and social media platforms.
Complete Registration