Clinton Baptist Church VBS Online Registration Form
Form
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date
-
Month
-
Day
Year
Date
Male or Female
Age
Names Of Siblings Attending
Phone Number
Please enter a valid phone number.
Alternate Emergency Phone Number
Do You Need Transportation? (Clinton Area Only)
Yes
No
Signature (this gives us permission to care for your child on site, and to use VBS photos/videos of your child on the church websites)
Submit
Should be Empty: