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Participant Registration

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Registro en Español

Victory Church

Location

810 Buena Vista Way

Chula Vista, CA 91910

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Contact Mike Chastain:

619-262-4444

victory.kids@victorysouthbay.org

First, Tell Us About Yourself:

Parent Information

Registration is available to potty-trained* K through 5th grade students.

*We will not have diaper changing services available.

First Name

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Last Name

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Address 1

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Address 2

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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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Contact Phone 2

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Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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Alternate Pickup Name

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Alternate Pickup 2 Name

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ID checks will be required to pick up children at the end of each day's program. This includes any Alternate Pickup designations.

Acknowledge ID Check

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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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Grade Entering

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Gender

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Date Of Birth

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Allergies

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Medical Concerns

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By registering for this program, you consent to photographs and/or audio/video/film of your child(ren) that may be utilized in media that includes, but is not limited to, the following: church bulletin boards, church newsletters, church websites, church projects, newspaper articles, television coverage, websites, internal or external publications, video presentations, and/or church presentations.

Media Release

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Comments

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Do you have friends you would like to be placed with? We will do our best to group selected friends together in the same crew, but we cannot promise all requests will be possible.

Friend 1 First Name

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Friend 1 Last Name

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Friend 2 First Name

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Friend 2 Last Name

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