Registrations

YM360 YOUTH CAMP

Camp registration form and waivers

Camper Information

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number

Birthdate

Grade

Allergies

Medications needed

Yes

List Medications and Dose

Medical Insurance Information

Parent Information

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number

Emergency Contact Information

In the event we cannot reach you.

First Name

Last Name

Phone Number

Relationship to camper

Waivers and Permissions

Medical and Media release

Medical

I give permission for CBC to get my child(ren) medical assistance if it is needed at any facility (ER or Urgent Care)

Multiple Choice

Yes

Media

I give permission for the representatives of CBC to photograph and or video my child(ren) during this event. Photos or videos may be used on social media and the church website.

Multiple Choice

Yes

Parental Consent

I give CBC and representatives of CBC permission to take my child(ren) on the Youth Summer Camp trip to Covenant College.

Signature

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Central Baptist Church VBS 2026

We are so excited for you to attend our VBS this year! Children age 3 through 6th grade are welcome to attend. Please fill out the information below to register. Our VBS is June 7th-11th from 6:00-8:30pm each night. We look forward to seeing you June 7th at 6pm! Be sure your child gets a free T-shirt on their first night with us! We will have a family night on Thursday, June 11th, for the parents to see what we have learned about our Lord and Savior!

Child's Information

First Name

Last Name

Birthdate

Grade

age

Allergies or Medical Information

Any special needs

T-Shirt Size

Church currently attending (if any)

Parent/Guardian Information

First Name

Last Name

Phone Number

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Emergency contact if we cannot reach you. Name and number

Photo/Video Authorization

We take photographs and videos of the children during VBS showing them learning and them doing activities. Those photographs and videos are used on our website, social media and to promote future events.

I allow my child to be photographed

Yes

Signature

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Submit

Registrations

YM360 YOUTH CAMP

Camp registration form and waivers

Camper Information

Parent Information

Emergency Contact Information

In the event we cannot reach you.

Waivers and Permissions

Medical and Media release

Medical

Media

Parental Consent

Central Baptist Church VBS 2026

Child's Information

Parent/Guardian Information

Photo/Video Authorization

Service Times

Contact Info

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