VBS Student Registration

Instructions: 
Use this form to register Students who have completed K4 through 5th Grade for CSP VBS 2018.
*Starred items are required. 
Your registration is complete when you click the 'SUBMIT MY REGISTRATION' button below and see the word SUCCESS!

Student Information
Student's Name *
Student's Name
Any Allergies or Medical Concerns? *
Family Information
Parent/Guardian's Name *
Parent/Guardian's Name
Address *
Address
Primary Phone # *
Primary Phone #
Secondary Phone #
Secondary Phone #
Home Church *
Emergency Contact Information
Emergency Contact's Name *
Emergency Contact's Name
Emergency Contact's Phone Number *
Emergency Contact's Phone Number
Authorization for Pickup
The following person(s) are permitted to pick up my child
Authorized Person's Phone # *
Authorized Person's Phone #