New Antioch Baptist Church
Tuesday, June 18, 2013
Leading everyone we touch to know Jesus Christ and follow Him.

VBS Registration

 
Child's Name  
 
Parent/Guardian Name 
 
Address 
 
Phone 
 Cell  
 
Email
 
Birthdate
Last Grade Completed In School  
Medical Information (Include Food Allergies)
Emergency Contact
Permission to photograph your child? yes
                                                       no
Who may pick up your child at the end of each VBS day?
 Do you attent church? yes    Where?
                                  no