SCUBA VBC Registration for Pre-K-4-year-olds through 5th Grade Graduates (2024)

Parent/Guardian Information

Parent/Guardian #1-First & Last Name

Parent/Guardian #1-Email

This address will receive a confirmation email

Parent/Guardian #1-Phone

Parent/Guardian #1-Address

Church Home (If any)

SCUBA Music-Each family receives either a Stellar Music CD or Download Card for the music children will learn at camp. Please indicate your preference.

CD Download Card

Parent/Guardian #2-First & Last Name

Parent/Guardian #2-Email

Parent/Guardian #2-Phone

Parent/Guardian #2-Address

Church Home (If any)

Child #1

Child's First & Last Name

Gender

Male Female

Date of Birth (MM/DD/YY)

Entering Grade for 2024-2025 School Year

Pre-K-4 K 1 2 3 4 5 6

Child's allergies, health concerns, or special needs

Child has no known allergies, health concerns or special needs

T-Shirt Size

I give permission for my child's photo to be used anonymously in Waypoint Church publications for ministry purposes.

Yes No

Please list same aged/grade friends your child would like to have in their crew.

Child #2

Child's First & Last Name

Gender Male Female

Date of Birth (MM/DD/YY)

Entering Grade for 2024-2025 School Year Pre-K K 1 2 3 4 5 6

Child's allergies, health concerns, or special needs

Child has no known allergies, health concerns or special needs

T-Shirt Size Youth X-Small Youth Small Youth Medium Youth Large Adult Medium

I give permission for my child's photo to be used anonymously in Waypoint Church publications for ministry purposes. Yes No

Please list same aged/grade friends your child would like to have in their crew.

Child #3

Child's First & Last Name

Gender Male Female

Date of Birth (MM/DD/YY)

Entering Grade for 2024-2025 School Year Pre-K K 1 2 3 4 5 6

Child's allergies, health concerns, or special needs

Child has no known allergies, health concerns, or special needs

T-Shirt Size Youth X-Small Youth Small Youth Medium Youth Large Adult Medium

I give permission for my child's photo to be used anonymously in Waypoint Church publications for ministry purposes. Yes No

Please list same aged/grade friends your child would like to have in their crew.

Child #4

Child's First & Last Name

Gender Male Female

Date of Birth (MM/DD/YY)

Entering Grade for 2024-2025 School Year Pre-K-4 K 1 2 3 4 5 6

Child's allergies, health concerns, or special needs

Child has no known allergies, health concerns or special needs

T-Shirt Size Youth X-Small Youth Small Youth Medium Youth Large Adult Medium

I give permission for my child's photo to be used anonymously in FPCSM publications for ministry purposes. Yes No

Please list same aged/grade friends your child would like to have in their crew.

Emergency Contact Information

Emergency Contact Name

Emergency Contact Phone

Relationship to Child(ren)

Parent/Legal Guardian Permission for Child(ren)'s Participation and for Emergency Medical Treatment

For legal and insurance purposes, parents/legal guardians are required to give permission for their child(ren) to participate in church-sponsored activities. I understand that my child(ren) will be under adult supervision at all times. Participants or parents of children participating in church-sponsored activities covered by church insurance are financially responsible for medical, hospital and pharmeceutical expenses above the amount paid by the insurance company for any injury or illness sustained during activities sponsored by the church. In the even of accident or illness, I give my permission for emergency treatment by qualified medical personnel for my child(ren).

By checking this box, I am providing my digital signature on this Form.

Payment

For PayPal Credit or Debit please select the number of children you are registering from the dropdown menu. To pay by Cash, Check or Zelle, select the "Pay by Cash/Check/Zelle" option.

Cash/Check Payments:
Waypoint Church
194 W. 25th Avenue
San Mateo, CA 94403

To make payment via Zelle, use the following email address which is linked to our Waypoint bank account: melissab@waypoint.church. If asked for a Recipient Name you can use "Waypoint" for the first name and "Church" for the last name.

For scholarship information, please email gladysg@waypoint.church

SCUBA VBC Registration for Pre-K-4-year-olds through 5th Grade Graduates (2024)

Description

Please Fix the Following