Vacation Bible School Registration Form

6-3-15_VBS_WEB.jpg   Hilldale Baptist Church

Child's Name______________________________________________

Parent/Guardian Name_________________________________________

Address (street address, city, state, and zip code)

____________________________________________________________

Phone Numbers

Home____________      Cell______________   Work_____________

Email ____________________________________________________

Birth date___________   Last grade completed in school___________

Medical or other information we need to know.  (Please include any food allergies.)

________________________________________________________

________________________________________________________

________________________________________________________

Emergency Contacts

Name ____________________________  Phone # ________________________

Name ____________________________  Phone# _________________________

 

Who may pick up your child at the end of each VBS day? ______________________________________

Do you attend Sunday School?  If so where? ____________________________________________________

If you are visiting our church, who are you a guest of? _________________________________________

May we have permission to photograph your child?       YES         NO

May we have permission to use your child's photograph for the purpose of promotion?           YES       NO

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