First Baptist Church of Newalla
Wednesday, September 08, 2010
Making Disciples to Make a Difference
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VBS Child Registration
Ready to join us on Saddle Ridge Ranch?! We can't wait to see you! Please fill out the form below to register your child for this exciting week!
Parent Name:
Parent Phone:
Parent Email:
Parent Address:
Additional Emergency Contact Name:
Emergency Contact Relation:
Emergency Contact Phone:
Child Name: Grade JUST COMPLETED: Allergies?
SELECT ONE
Kindergarten
1st
2nd
3rd
4th
5th
6th
SELECT ONE
Kindergarten
1st
2nd
3rd
4th
5th
6th
SELECT ONE
Kindergarten
1st
2nd
3rd
4th
5th
6th
SELECT ONE
Kindergarten
1st
2nd
3rd
4th
5th
6th
Would you like information about the bus service offered during VBS?
Yes
No
Do you attend church regularly? If so, where?
Additional Comments:
NOTE - All fields above are REQUIRED to submit the form.