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CHBC Vacation Bible School Registration Form 2021
Event Timing: June 6-10th, 2021 from 5:30-8:00 pm
Event Address: 4427 US-127 Crossville, TN 38555
Contact us at (931) 484-5523 or
homesteadsbc@gmail.com
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* Indicates required question
Child's Name
*
Your answer
Parent/Guardian Name
*
Your answer
Address
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Your answer
Phone Number(s)
*
Your answer
Email
*
Your answer
Child's Birth Date
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Your answer
Last grade completed in school
*
2s-3s
Pre-k (4s-5s)
Kindergarden
1st
2nd
3rd
4th
5th
6th
List any medical information we need to know (please include food allergies)
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Your answer
Emergency Contact Names & Phone Numbers
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Your answer
Who may pick up your child at the end of VBS each day?
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Your answer
Do you/your child attend church anywhere? If so, where?
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Your answer
If your child is visiting our church, who is he/she a guest of?
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Your answer
May we have permission to photograph your child?
*
Yes
No
May we have permission to use your child's photograph for promotion purposes?
*
Yes
No
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