WonderCove 2018 Student Registration
***REGISTRATION IS NOW CLOSED. THANK YOU SO MUCH FOR YOUR INTEREST.***

July 23rd - 27th | 9:00am - 11:45pm
Community Bible Church | July 23rd - 26th
Family Beach Day @ Marina Park | July 27th
$15/Child or $20/Family
Pre-K to 5th Grade | Limited Spaces Available

Scholarships Available. Make checks payable to Community Bible Church, or pay with card at cbcventura.org/give/. Your Registration will be complete once payment has been completed.

For more information, please contact Katherine Nofziger at katherine@cbcventura.org or (805) 218-4133.
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Email *
Student name *
Gender
Birthdate *
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Grade *
Student has sibling(s) who are also attending WonderCove: *
Required
If you selected "yes", please include name(s):
Parent/Guardian name(s) *
Home Address *
Phone number *
My child is authorized to be picked up by the following people: *
Emergency contact name *
Emergency contact's relation to child *
Emergency contact's phone number *
Student: Allergies, medical condition or other important information *
Please select any that apply:
Authorization: If my child is injured in an accident or becomes seriously ill, and I or my designee cannot be reached, I authorize Community Bible Church to arrange for the transportation of my child to a licensed emergency medical care facility to receive prompt treatment. Furthermore, I authorize the medical personnel at the facility to provide such treatment to my child as is indicated by the nature and extent of his or her injury and that is in accordance with the protocols of standard medical practice. I understand I am responsible for my child's supervision during the Family Beach Day, July 27th. Finally, I accept full financial responsibility, for all costs, charges, and fees associated with the transportation of my child and for the treatment provided by the medical care facility to my child and absolutely and unconditionally agree to indemnify and to hold Community Bible Church harmless from all such costs, charges, and fees. By selecting below, I agree to the above statements. *
Required
Parent/Legal Guardian Name *
Date *
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YYYY
Signature, Date (Sign in person)
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