Emerald Crossing at Cornerstone Baptist Church

Family Information

Address

Street

Street 2

City

State/Province

Postal Code

Parent/Guardian First Name

Parent/Guardian Last Name

Primary Phone

Parent/Guardian First Name

Parent/Guardian Last Name

Secondary Phone Number

Emergency Contact

Relationship to Student

Phone Number

Is there anyone who is NOT allowed to pick up your child(ren)? If yes, please list their name.

Drop Off/Pick Up Procedure

I acknowledge that only individuals designated as a parent or guardian, or those listed as emergency contacts, are allowed to drop off or pick up my child(ren). Additionally, my child(ren) must be escorted in and out of the building by at least one of these authorized adults. Drop off will be from 5:50-6:00 PM and Pick up will be from 8:30-8:45 PM. I understand and agree to these procedures.

I agree

Photo/Video Release

I hereby grant permission for Cornerstone Baptist Church to record sounds, images, or video of my child(ren) while attending the VBS program. I also give permission for Cornerstone Baptist Church, at its sole discretion, to use these sounds, images, or videos in publications (including print, websites, and social media platforms) owned by Cornerstone Baptist Church.

I agree

Register for VBS

at Cornerstone Baptist Church

Family Information

Address

Student Information