CPC Vacation Bible School Registration
Please complete the fields below to register your child(ren) for Vacation Bible School.  This epic African adventure engages the whole herd. At Roar, kids explore God’s goodness and celebrate a ferocious faith that powers them through this wild life.!  The dates for this year's program are July 29-August 2 from 9:00-12:00.
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Email *
How many children are you registering today?  Registration is $20.00 per child.
In the spaces below, please list your child(ren)'s name(s) along with their age, grade, and t-shirt size.
Child #1 (Name, age, grade, t-shirt size)
Child #2 (Name, age, grade, t-shirt size)
Child #3 (Name, age, grade, t-shirt size)
Child #4 (Name, age, grade, t-shirt size)
Child #5 (Name, age, grade, t-shirt size)
Parent/Guardian Names & Contact Information
Name (first and last)
Phone Number
Email Address
Name (first and last)
Phone Number
Email Address
Emergency Information & Contact
Describe any allergies/restrictions or medically related information we should be aware of regarding your child(ren).  Please be name-specific.
Please list an emergency contact for your child(ren) - first/last name (for safety purposes, no one under age 18 may pick up the child)
Emergency Contact Phone Number
In the event you are not able to pick up your child(ren) from VBS on any given day, please list the names of all authorized adults who may pick up your child(ren).
Acknowledgements & Agreements
In registering my family for this Catoctin Presbyterian Church program, I propose that my children are in good physical condition and acknowledge that there is inherent risk in any activity, and do hereby agree to hold harmless the Catoctin Presbyterian Church, its board, its staff, and volunteers from any course of action stemming from my children's participation in this program. I understand that any photos taken of my children’s participation in the Catoctin Presbyterian Church events may be used in publications and promotions of the Catoctin Presbyterian Church. I also authorize Catoctin Presbyterian Church, its staff or agents, to render or obtain such emergency medical care or treatment as may be necessary should any sickness, injury, harm, or accident occur while participating in the activity.
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