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Participant Registration

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Cornerstone Presbyterian Church

Location

109 Gypsy Hill Road

Landenberg, PA 19350

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Contact Jen Smith:

610-255-5512

jensmithcornerstone@gmail.com

First, Tell Us About Yourself:

Parent Information

First Name

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Last Name

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Address 1

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City

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State/Province

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ZIP/Postal Code

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Contact Phone 1

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By registering for VBS, your contact information becomes part of the church database and you will begin to receive weekly emails. There is always the option to unsubscribe.

Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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Home Church Affiliation

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How did you hear about Cornerstone's VBS?

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List ALL adults who are authorized to pick up your child(ren), including yourself

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I hereby release Cornerstone Presbyterian Church of any responsibility of accident or injury that may occur during VBS. I authorize my child(ren) to receive the proper treatment and/or hospitalization after a reasonable attempt is made to contact the parent or emergency contact.

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I give permission for any photos or videos of my child(ren) to be used on all Cornerstone publications, websites and social media accounts (YouTube, Instagram, Facebook)

Multiple selections are allowed.

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Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Tell Us About Your Participant

First Name

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Last Name

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Gender

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Date Of Birth

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Please note: Pre-K 3 and Pre-K4 are ONLY for Cornerstone and Cornerstone Preschool children.

Nursery is ONLY for children of adults who are volunteering all week.

Grade Entering

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Allergies

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Medical Concerns

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Does your child have any special needs? If so, please share with us how we can make VBS a comfortable environment for him/her. If you would like our Disability Ministry Coordinator to contact you, please indicate that as well.

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Comments

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