2022 VBS Registration
CrossPointe Fellowship is delighted to have your child be A-MAZE-D during this summer's VBS!

PLEASE NOTE: If you are NOT the PARENT or LEGAL GUARDIAN of the child(ren), please send the link to this form to them. Thank you!

Attaching a PHOTO of each child is a huge help in making Monday morning of VBS run smoother for you and for us. Thank you for doing that!
  • VBS NOTE

    Please be aware that VBS is in the EVENING this year (6:00-8:15) and that we will be grouping according by 2022-2023 grades. If you have any concerns/questions, please contact Steve or Tanya DeWitt. The church office can supply contact info.
  • FAMILY INFORMATION

    You'll enter personal information on each child following this section.
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  • Your local street address
  • OTHER ADULTS

    If anyone OTHER than adults named above may pick up your children, please include that information here:
  • STUDENT INFORMATION

    First Child
  • Nickname? Include in parentheses after First Name [Susan (Sue) ]
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  • Second Child
  • Nickname? Include in parentheses after First Name [Susan (Sue) ]
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  • Third Child
  • Nickname? Include in parentheses after First Name [Susan (Sue) ]
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  • Fourth Child
  • Nickname? Include in parentheses after First Name [Susan (Sue) ]
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  • Fifth Child
  • Nickname? Include in parentheses after First Name [Susan (Sue) ]
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  • As a PARENT or LEGAL GUARDIAN of the Minor(s) listed above,
  • 1. I understand that my child/children/ward(s) [hereinafter called “child” whether singular or plural] will participate in physical activities while attending VBS at CROSSPOINTE FELLOWSHIP (also referred to as CPF,) and, as with any physical activity, there is a risk of injury or death. I understand that these activities may include, but are not limited to, a cardboard maze, playground equipment, a zip-line, “nerf wars”, crafts (including the use of normal craft supplies and equipment), and a variety of classroom activities that may include tossing balls and similar actions. I understand I have the right and obligation to notify CROSSPOINTE FELLOWSHIP in writing if I do not wish my child to participate in a specific activity. 

    Despite all known and unknow risks, I fully agree to hold harmless from any legal liability CROSSPOINTE FELLOWSHIP and any persons involved in the ministries of CROSSPOINTE FELLOWSHIP. I release any and all rights and claims for damages my child may have against CROSSPOINTE FELLOWSHIP, its volunteers and staff for any and all injuries or death suffered while attending VBS and while on CPF property before or after VBS. This includes any and all medical and legal bills.
  • 2. I give my permission for the CROSSPOINTE FELLOWSHIP staff and volunteers to administer needed first aid to my child.  In the event of an emergency that requires medical treatment, I understand that VBS leaders will try to contact me and, if I cannot be reached, I authorize the CROSSPOINTE FELLOWSHIP staff and volunteers to use emergency medical services (911) as necessary for my child's wellbeing. I also agree to assume all costs connected to any accident or treatment of my child.
  • 3. I understand that anyone at CROSSPOINTE FELLOWSHIP during VBS, including myself, my spouse, my child, and other family members, may be photographed, videoed, and/or recorded and that these media records may be used for purposes including, but not limited to, posting on websites and social media and including in printed materials, including newspapers. I grant permission for these photographs, videos and other media to be used in this manner. If I do not wish to grant permission, I will notify CROSSPOINTE FELLOWSHIP in writing.
  • NOTICE TO THE MINOR CHILD’S NATURAL GUARDIAN


    READ THIS FORM COMPLETELY AND CAREFULLY.

    YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN POTENTIALLY DANGEROUS ACTIVITIES.

    YOU ARE AGREEING THAT, EVEN IF CROSSPOINTE FELLOWSHIP USES REASONABLE CARE IN PROVIDING THESE ACTIVITIES, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THESE ACTIVITIES BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITIES WHICH CANNOT BE AVOIDED OR ELIMINATED.

    BY SIGNING THIS FORM, YOU ARE GIVING UP YOUR CHILD’S RIGHT AND YOUR RIGHT TO RECOVER FROM CROSSPOINTE FELLOWSHIP IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITIES. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND CROSSPOINTE FELLOWSHIP HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.
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  • THANK YOU for allowing us the privilege of having your children in our activities. Please call the office (941.778.0719) if there are special circumstances you need to discuss.

    By submitting this form, you acknowledge that all information is correct and that you agree to the above statements.