Emergency Contact #1 (Somebody who has permission to pick up your child if needed) *
Your answer
Emergency Contact #1 Home Phone *
Your answer
Emergency Contact #1 Cell Phone *
Your answer
Emergency Contact #1 Work Phone
Your answer
Emergency Contact #2 (Somebody who can pick up your child if needed) *
Your answer
Emergency Contact #2 Home Phone *
Your answer
Emergency Contact #2 Cell Phone *
Your answer
Emergency Contact #2 Work Phone
Your answer
Allergies or Health Concerns *
Your answer
Does your child carry an epi-pen? *
Physician's Name *
Your answer
Doctor's Phone Number *
Your answer
If your child is injured or sick, we will make every attempt to contact you. However, if there is an emergency and we are unable to reach you or your emergency contacts, do we have permission to seek medical attention for your child? *
Is there anything we should know about your child or are special accommodations needed to help VBS be a positive experience for them?
Your answer
Do we have permission to use your child's photo or video for marketing purposes in print materials, on our website, and/or social media? *
Would you like us to provide a sack lunch for your child each day? (lunch includes a ham & cheese sandwich, fruit, juice box and cookie) *
Do you attend a local church? *
If so, which church do you attend?
Your answer
Is there anything else you would like us to know?
Your answer
Thank you for registering your child for Creation Camp VBS. We will be in touch over the Summer with confirmation of your child's enrollment. If you have any questions or concerns, please email us at melissa.marzolf@ctksnohomish.org.