2025 Crosswater Kids Camp

Registration

Registration Type

Volunteer

Child

Volunteer Info

First Name

Last Name

Phone Number

Email

Are you a student helper?

Yes

No

Age

Please choose the role you'd most like to help with;

Please choose a backup option

First Name

Last Name

Email

Phone Number

First Name

Last Name

Gender

Birthdate

Current Grade (VBS is for students entering K-5th grades)

Allergies

Is there a special friend your child would like to be with?

Person Responsible for Pickup after VBS

Their Phone Number

Additional Pickup Person

Their Phone Number

Photography/ Video Release: I hereby give consent for my child to be photographed or videoed for promotional use by Crosswater Community Church. They will not be forwarded to any third party. (*note: this applies to all children included in this registration)

Yes

No

Emergency Contact (other than parent listed above)

First Name

Last Name

Phone Number

Medical Insurance Provider & Policy #

Doctor's Name

Doctor's Phone Number

Please list any medications that we need to be aware of

I, the parent or guardian, herby give approval for my child(ren) to attend and participate in the activities of the 2025 Kids Day Camp at Crosswater Community Church. I relieve Crosswater Community Church and all affiliated staff from any and all liability for sickness, accidents, or injuries while attending and participating. In the event of an emergency and I cannot be contacted I give my consent to the staff of Crosswater Community Church to authorize medical help on site or at an appropriate medical facility.

Yes

No

Signature

2025 Crosswater Kids Camp

Registration

Volunteer Info

Emergency Contact (other than parent listed above)

About

Service Times

Contact Info

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