VBS Registration

PARENT'S INFORMATION
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Parent's First Name (required)

Parent's Last Name (required)

Address 1(required)

Address 2

City (required)

Province (required)

Postal Code (required)

Parent's Email (required)

Parent's Phone (required)

EMERGENCY CONTACT #1
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First Name (required)

Last Name (required)

Phone # (required)

EMERGENCY CONTACT #2
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Emergency Contact #2

First Name (required)

Last Name (required)

Phone # (required):

PERMISSIONS
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I give permission for my child(ren) to participate in activities at Cariboo Road Christian Fellowship.
yesno

I give permission for Cariboo Road Christian Fellowship to take pictures of my child(ren) to use for publicity if our program in print and on our website as well as other non-promotional uses.
I give permissionI don not give permission

I have read all the information on this registration form.
YesNo

CHILD BEING REGISTERED
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Number of children in this registration: 123

Note: If you are registering one child, please fill in the details for CHILD #1 only. Thanks.

Child #1

Child's First Name (required)

Child's Last Name (required)

Grade completed in June 2017 (required)

Date of Birth (MM/DD/YYYY) (required)

Age (required)

Food Allergies (Yes or No) (required)
yesno

If Yes, Explain

Are there any other medical concerns we should be aware of ? If Yes, Explain

Does your child have any behavioural issues, designations or does your child receive one-on-one support at school ?
yesno

If Yes, Explain

Child #2

Child's First Name

Child's Last Name

Grade completed in June 2017

Date of Birth (MM/DD/YYYY)

Age (required)

Food Allergies (Yes or No)
yesno

If Yes, Explain

Are there any other medical concerns we should be aware of ? If Yes, Explain

Does your child have any behavioural issues, designations or does your child receive one-on-one support at school ?
yesno

If Yes, Explain

Child #3

Child's First Name

Child's Last Name

Grade completed in June 2017

Date of Birth (MM/DD/YYYY)

Age

Food Allergies (Yes or No)
yesno

If Yes, Explain

Are there any other medical concerns we should be aware of ? If Yes, Explain

Does your child have any behavioural issues, designations or does your child receive one-on-one support at school ?
yesno

If Yes, Explain

AFTERNOON PROGRAM
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Fun Maker Factory VBS officially ends at noon. We will also be running an afternoon program which will be available from noon - 3:30pm for an additional $25.00 per child. Please indicate if your child will be staying for the afternoon program as well as the VBS.

My child(ren) will be staying for Afternoon Programs yesno

We just want to be sure that you are not a robot. Please check the box below

Please note: You will be redirected to the payments page once you click the Register Now button.