Register for VBS

Family Information

Primary Phone

Address 1

Church Affiliation

Other

Details

Phone

Address 2 (if different than above)

Church Affiliation (if different than above)

0ther

Details

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

Address

Medical

Food Allergies

Details

Medical Concerns

Details

Drop off/Pick up

An adult will be required to sign in child(ren) upon arrival. Please list anyone in addition to parents, guardians and emergency contacts who may be picking up children.

Pick up

Details

My children will be walking home after VBS

Consent

I am a legal parent/guardian of child(ren) listed and grant permission for their participation in all VBS activities at Canyon Bible Fellowship from July 14 - July 18, 2025 between the hours of 9:00am and 11:30am, unless otherwise noted. I understand that all reasonable safety precautions will be taken and I release, hold harmless and indemnify CBF and VBS representatives from all liability, claims and costs associated with the VBS program. I understand that in the event of a medical emergency, every attempt will be made to first contact the parents, guardians and emergency contacts listed on this form. I authorize for my child(ren) to receive the medical attention deemed necessary in the event of injury or illness, as directed by representatives of Santiam Canyon VBS.

Photo Release

Videos and photos may be used for (select all that apply) Names and other identifying material will not be included.

Questions/Comments

Signature

I have more students to register