The Great Jungle Journey at CrossPointe Church Fleming Island

Family Information

Parent/Guardian First Name

Parent/Guardian Last Name

Phone Number

Primary Phone

Alternate Phone

Address

Street

Street 2

City

State/Province

Postal Code

Emergency Contact

Relationship to Student

First and Last Names of Adults allowed to pick up your child(ren) after VBS

How many children from your family will be attending VBS? (Ages 0-17)

I understand that VBS is from 6:30pm to 8:30pm and my child(ren) will be picked up by someone on the authorized list in the first section at 8:30pm.

I agree

I understand that my child(ren) my be photographed/recorded for an end of VBS slideshow/video to be shown at the closing ceremony. Some photos may be posted on our church social media or websites.

Register for VBS

at CrossPointe Church, Fleming Island

Family Information

Address

Student Information