VBS Application 2013
To pay online complete and submit the registration form and complete the payment of $10 (per child) at the end through paypal. Or click here for a printable version of the VBS registration form that can be dropped off at Clovis Christian Church office with the $10 (per child) payment.
Fields marked with a "*" are required.
Home Church: None
This Child has a known helath condition Yes No If so, please explain:
Name of Medical Insurance:*
Consent for Medical Treatment (minor): As the parent or legal guardian of the above named children, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medical Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent. This authorization will stand until revoked by me in writing.
Electronic Singature (type full name):*
For more information
on Children's Ministry contact us!