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X-WR-CALNAME:Christ Baptist Church - Burlington, NJ
X-ORIGINAL-URL:https://cbcburlingtonnj.org
X-WR-CALDESC:Events for Christ Baptist Church - Burlington, NJ
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DTSTART;TZID=America/New_York:20261023T183000
DTEND;TZID=America/New_York:20261024T120000
DTSTAMP:20261009T151654Z
CREATED:20261009T145627Z
LAST-MODIFIED:20261009T151654Z
UID:10003728-1792780200-1792843200@cbcburlingtonnj.org
SUMMARY:Overnight Shut-In
DESCRIPTION:Please enable JavaScript in your browser to complete this form.WHEN: Friday\, October 23 to Saturday\, October 24\, 2026\nWHERE: Christ Baptist Church\nWHO: Ages 10 to 17 \nAdditional Information \nDinner and breakfast will be served. Activities include video games\, board games\, prayer\, and worship\, among others. \nPlease bring a sleeping bag/blanket/pillow along with your nighttime materials (PJs\, toiletries\, etc.) \nThe child and/or parent MUST be a member of Christ Baptist Church to attend the shut-in event.\n\n				Parent/Guardian Information\n			Parent/Guardian Name *FirstLastParent/Guardian Number *Parent/Guardian Address *Address Line 1Address Line 2CityNJAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Code		\n			Are Medications \n			\n		\n		How many children are you registering? *- Please select -1234567Are you and/or your child(ren) a member of Christ Baptist Church?  *- Please select -YesNoIf you selected NO\, your child(ren) cannot attend the retreat. \n				Child's Information & Medical Information\n			Name  *FirstLastDate of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Grade *Gender *- Please select -MaleFemaleAge  *Must be 8 years old or olderMedical conditions?  *- Please select -YesNoDoes your child have any known allergies?  *- Please select -YesNoIf Yes\, please list known allergies.Any specific dietary requirements? *- Please select -YesNoCurrent Medications (if applicable)Special Instructions\n				\n					Add Child\n				\n				\n					Remove\n				\n			\n				Emergency Contact Information\n			Name *Number *EmailRelationship to Child *FatherMotherGrandparentGuardianSiblingFamily Friend\n				Consent\, Agreement & Authorization\n			I\, the undersigned\, am the parent/legal guardian of the child named above. I give my full consent for my child to participate in the event specified.Liability Waiver *My family and I hereby waive and release the Christ Baptist Church\, its Pastor\, officers\, employees\, volunteers\, or other representatives from all claims for damages and/ or injuries incurred while participating in or as a spectator at a Christ Baptist Church sponsored activity. I have read and understand the registration policies. Registration is invalid without signature.Waiver and Release of LiabilityMedical Treatment *I understand that I will be notified at once in case of illness or accident involving my child\, and I will make arrangements for medical care of my child with the physicians or hospital of my choice. If I cannot be reached to make neccessary arrangements or in a critical emergency requiring medicial treatment\, I hereby authorize Christ Baptist Church/ Vacation Bible School to contact Emergency Medicial Services for transport to an emergency care facility. I understand that emergency personnel may choose to contact my child's physician listed below:Field #41 (copy) *By applying my electronic signature to this agreement\, I agree that my electronic signature is the legally binding equivalent of my handwritten signature on paper. I will not\, at any future time\, claim that my electronic signature is not legally binding or enforceable. By electronically signing and submitting this agreement\, I 1) acknowledge that I have read and fully understand the terms of the agreement; 2) voluntarily agree to be bound by this agreement; and 3) certify that I am 18 years of age or older. My signature applies to all pages of this contract. I understand that if I wish to sign a hard copy of this agreement instead of an electronic version\, I must contact the party that requires my signature on this agreement directly.  A parent or legal guardian must sign this agreement on behalf of any minor participant under the age of 18. By electronically signing this agreement\, I represent that I have the authority to sign and enter into this agreement on behalf of the minor(s) listed above.Signature: PRINT NAME BELOW to sign release *Submit
URL:https://cbcburlingtonnj.org/event/overnight-shut-in/
LOCATION:Christ Baptist Church Burlington NJ\, 950 Jacksonville Road\, Burlington\, NJ\, 08016\, United States
CATEGORIES:8:28 EVENTS,JAMM
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