2026-27: Child/Student Registration Form

  • 2026-27: Child/Student Registration Form

  • My family regularly attends:*

  • 1.Child/ Student

  • Gender*
  • Date of Birth*
     / /
  • Child/Student Participates in the Following Ministry(s) - Please check all that apply*

  • Family Preferred Contact Information

  • Can we add you to the Kids Ministry Text reminders and updates list?
  • Adult 1*

  • Format: 000-000-0000.
  • Can we add you to the Kids Ministry Text reminders and updates list?
  • Adult 2

  • Format: 000-000-0000.

  • Emergency Contact if parents cannot be reached

    (Other than mother/father)
  • Format: 000-000-0000.

  • Additional Children/Students Participating in SHBC Activities

    Please complete this page if you have any additional children that will participate in Spring Hills Baptist Church activities.
    • 2. Child/Student 
    • Gender
    • Date of Birth
       / /
    • Child/Student Participates in the Following Ministry(s) - Please check all that apply
    • 3. Child/Student 
    • Gender
    • Date of Birth
       / /
    • Child/Student Participates in the Following Ministry(s) - Please check all that apply
    • 4. Child/Student 
    • Gender
    • Date of Birth
       / /
    • Child/Student Participates in the Following Ministry(s) - Please check all that apply
    • 5. Child/Student 
    • Gender
    • Date of Birth
       / /
    • Child/Student Participates in the Following Ministry(s) - Please check all that apply
    • 6. Child/Student 
    • Gender
    • Date of Birth
       / /
    • Child/Student Participates in the Following Ministry(s) - Please check all that apply
    • 7. Child/Student 
    • Gender
    • Date of Birth
       / /
    • Child/Student Participates in the Following Ministry(s) - Please check all that apply

  • Permissions

  • These additional individuals are authorized to pick up this child(ren) from SHBC ministries or events. (In addition to parents and the Secondary Emergency Contact) 

  • Are there any persons not allowed to have contact with, or pick up, your child(ren)? *** If yes, please contact Spring Hills Safety & Security Director, Marvin Rutter, to provide necessary information 740-403-1819*
  • Date
     / /
  • Format: 000-000-0000.

  • OR in the event the appropriate specified practitioner is not available, by another licenced physician or dentists:

    2. The transfer of minor to preferred hospital or any hospital reasonably accessible.

  • 3. This authorization does not cover major surgery unless the medical opinions of two other licensed physicans or dentists concurring in the necessity for such surgery are obtained in writing prior to the performance of such surgery.

  • Date
     / /
  • Should be Empty: