Register Your Kids

Please register each child separately.  Thank You!

Child's First & Last Name (required)

Child's Birthdate: MM/DD/YYYY (required)

Child's Age (required)

Last School Grade Completed (required)

Parent's Name(s) (required)

Parent's Email (required)

Home Phone (required)

Emergency Phone (required)

Street Address (required)

City (required)

Zip (required)

Home Church (list none if you don't have a home church) (required)

A power point presentation of this year's VBS will be shown during worship services and possibly be posted on facebook and Vimeo. Can we use your child's picture in the presentation? (required)

I the undersigned parent or guardian of the above child, do release and hold harmless the Crossing Church of the Nazarene and its representatives, from any and all damages or liabilities arising out of any sickness or accident occurred by my child. (required)
Medical Release Granted

Please list any medical allergies, medications taken, food allergies or other pertinent information (if none, please list none): (required)

Please list any physical restrictions your child has that would limit participation by him/her in any activities (if none, please list none): (required)

Your child will not be released to anyone who does not have your security badge. If there is anyone NOT ALLOWED to pick up your child, please list their name here (if none, please list none): (required)
.

I understand that my child will be participating in activities at CCON and will be under the care and guidance of its sponsors. I give my permission for my child to participate fully. (required)
Participation Granted

I understand that my child's registration is INCOMPLETE UNTIL I sign the release form and pick up a security badge. I understand that I can complete this step by visiting the Online Registration table located in the lobby at CCON before/after weekend worship services starting Saturday, May 28 or on the first night my child attends VBS. (required)

A: 3501 W. 104th Ave
Westminster CO 80031

E: info@crossingchurch.org
P: 303.469.5149

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