VBS Registration Form


Child Information
* Children's Names * DOB (MM/DD/YYYY) Age Last Grade Completed Gender List Medical or Other Special Needs
 
 
 
 
 
 


* Parent/Guardian:
* Address:
* City:
* State:
* Postal/Zip Code:
* Main Phone:
Alternate Phone:
E-mail Address:
* Emergency Contact:
* Emergency Phone:
Do you attend church?
Yes No
Where?
Guest of:
Authorized Pickup(1):
Authorized Pickup(2):
  * Required Fields
 
Copyright © 2013 Calvary Baptist Church, All rights reserved
Calvary Baptist Church • 901 Montezuma Ave • Dothan, AL 36303  • 334-792-5159 . fax: 334-792-3061