VBS Registration Form

Sunday, June 28 - Thursday, July 2 • 6pm - 8:30pm

For ages 3 yrs old (must be potty trained) through entering 6th grade.

Parent/Guardian Name

This address will receive a confirmation email

Phone

Address

Work Phone

Child 1 Name (First & Last)

Child 1 Birthday

Child 1 Grade Entering in Fall

Child 2 Name (First & Last)

Child 2 Birthday

Child 2 Grade Entering in Fall

Child 3 Name (First & Last)

Child 3 Birthday

Child 3 Grade Entering in Fall

If you have more than three children to register, please fill out another form.

Medical/Other Information that we need to know. Please include food allergies & child’s name.

Emergency Contact Name

Emergency Contact Phone

May we photograph your child?

Yes No

May we use your child's photograph? (website, social media, slideshows, etc.)

Yes No

Does your child attend Sunday School? If so, where?

If your child is visiting our church, is (s)he a guest of someone here? If yes, whom?

I opt in to receive text messages from Hazelwood Baptist Church

Yes No

Description

Please fill out this form and click submit.