VBS Registration

Center Point Baptist Church 2021 Vacation Bible School Registration Form. VBS is geared for children who will be 4 years old or older by September 1, 2021. VBS will be held at Center Point July 11th- 14th 2021.

Child Information

* Indicates required field

Child's Name *

First

Last

Gender *

Birthdate *

Grade Entering *

Allergies *

Medical Information (If Any) *

Does child attend church regularly? *

Yes No

If yes, where? *

Parent Information

Parent's Name *

First

Last

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Emergency Contact Information

Emergncy Contact Name *

First

Last

Relationship to Child *

Phone Number *

Alternate Information

Alternate Pickup Name *

First

Last

Relationship to Child *

Alternate Pickup #2 Name *

First

Last

Relationship to Child *

Other Information

If your child is a preschooler, what age will he/she be on September 1, 2021? *

If your child will be 6 or 7 but not in the 1st grade yet, will they be placed with the 1st graders? *

Yes No

In case of an emergency, do we have your permission to transport this child by ambulance to Highlands Medical Center? *

Yes No

Comments *

Submit

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