Vacation Bible School Registration

Highland Hills Baptist Church Vacation Bible School
June 11-15, 2012 6:00p.m.-8:30p.m.
Ages 4 years-6th grade

Name

Age

Address

City / Zip

Home Phone

Cell Phone

Birth Date

Current or last grade completed in school (K-6)- this is child's VBS Class *

Do you go to Sunday School? If so, where?

Medical or other information we need to know:

In the event of an emergency, whom do we call? Name / Phone

Medical Release: I hereby give permission for the staff of Highland Hills Baptist Church to secure medical treatment for my child in the event of an emergency: *

Yes

IMPORTANT! Please read carefully: Choose one *

My Child has permission to to leave his/her classroom on his/her own at the end of the night.

My Child must be picked up. The responsible party must present a security card.

Email address: *

Please Note: Vacation Bible School hours are from 6:00pm until 8:30pm.
Please pick up your children on time each evening. Highland Hills Baptist Church does not assume responsibility for supervision of children after 8:45pm. Thank you for your cooperation.

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