Wonder Junction at Cornerstone Church

Family Information

IMPORTANT

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Address

Street

Street 2

City

State/Province

Postal Code

Parent/Guardian First Name

Parent/Guardian Last Name

Primary Phone

Alternate Parent/Guardian First Name

Alternate Parent/Guardian Last Name

Alternate Phone

Emergency Contact

Relationship to Student

Phone Number

Who else is authorized to pick up your child/ren from VBS? Please include first and last names.

Home Church (if any)

Authorization I give my child/ren permission to participate in the VBS program. I understand photos or videos may be taken and used by Cornerstone Church for promotional purposes. In the event that my child/ren would need medical treatment, I authorize representatives of Cornerstone Church to administer and/or seek medical treatment. I expect to be contacted as soon as possible following the need of medical treatment for my child/ren. Authorization will serve as your signature.

Yes

Questions/Comments

Register for VBS

at Cornerstone Church

Family Information

Address

Student Information