2026 VBS Registration

Child's Information

Name

Gender

Male Female

A calendar will open when you type the birthdate (ex. MM/DD/YYYY) Make sure to click the date on the calendar.

Birthdate

Age

What grade will your child complete this year?
*only select Pre-Kindergarten if your child is entering Kindergarten Fall 2026.

Grade

Pre-Kindergarten Kindergarten 1st 2nd 3rd 4th 5th

Address

Does your child currently attend CPC?

Yes No

Children will be grouped by grade. Please list a few friends your child has in the same grade. We will try to place children with atleast one friend. *Groups will not be adjusted during VBS due to logistics*

Parent/Guardian Information

Parent/Guardian Name

Parent/Guardian Relationship

Parent/Guardian Phone

Parent/Guardian Email

This address will receive a confirmation email

May we contact you by text message? *Most our of communications will come by text*

Yes No

Persons other than the parent/guardian listed authorized to pick up your child. Include name, relationship, cell phone number (ex. Jane Doe, grandmother, 706-000-0000)

Medical and Emergency Information

Please explain any food, medical or special needs your child may have.

Allergies

Medical Concerns or Special Needs

Emergency contact name and phone number other than the parent/guardian listed

Consent Waiver

Medical Consent:

In extreme medical emergency when neither parent can be immediately contacted, I give permission to the Children’s Ministry Director of Covenant Park Church or their designee to secure the services of professional medical attention.

Medical Consent Permission

Yes No

Photo Release:
I give permission for my child to be photographed and/or videotaped while participating in Covenant Park's VBS program. These photos may be used within the churches and/or published on the churches’ website or Facebook pages. Unless a child’s name tag is visible in a photo, no names or other identifying information of children in photos will be published.

Photo Release Permission

Yes No

Bounce House Participation Agreement:
I acknowledge that my child's participation in the use of the bounce house may involve risk to the participant and may result in various types of injury. In consideration for my child's participation in bounce house use, I acknowledge and accept the risks of injury associated with participation.

Bounce House Permission

Yes No

Further, I release and promise to indemnify, defend, and hold harmless the Covenant Park Church for any injury arising directly or indirectly out of the described activity, whether such injury arises out of the negligence of the activity sponsor or the participant.

I consent

Yes No

Tshirt Purchase

VBS themed T-shirts are available for you to purchase when registering your child. T-shirt payments are non-refundable.

Tshirt Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

2026 VBS Registration

Description

Please Fix the Following