VBS Registration
Vacation Bible School
July 15 - 19
9 AM - Noon
Parent/Guardian Name
Other information
Child's Name (1)
Child's Age (1)
Grade child going into (1)
City and State
Emergency Contact
Allergies for which child if more than one (Please put NONE if there are no allergies)
Insurance Company & Policy Number
Child's Name (2)
Child's Age (2)
Grade child going into (2)
Registration Form
Vacation Bible School is for children ages Kindergarten through Grade 6.  

You may pre-register by completing this form.
If you have any questions, you may contact the church office @ 719.495.3200 or [email protected]
By submitting this form, I do hereby give my permission for my child(ren) named above to attend and participate in all activities conducted at the Crossroads Chapel Vacation Bible School, July 15-19.

I further give my permission for any adult volunteer to obtain necessary medical attention in case of sickness or injury to my child.   I have identified any medical conditions that might require special attention in the above form.

I do hereby release and discharge all adult volunteers and Crossroads Chapel from any and all claims, demands, actions or cause of action, present or future arising out of any damage or injury while my child is in their care while attending Vacation Bible School and associate VBS events.