Clayton Baptist - VBS

Register Your Child

Parent First Name

Parent Last Name

Parent Phone Number

Email

Home Address

City

State

Zip Code

Emergency Contact: We will call this number if parent cannot be reached

Emergency Contact First Name

Emergency Contact Last Name

Phone Number

Permission to take Video/Photos of your child during VBS
Yes
No

Permission For Your Child To Walk Home
Yes
No

Do You Have A Home Church?

Child 1

First Name

Last Name

Allergies

Child 2

First Name

Last Name

Allergies

Child 3

First Name

Last Name

Allergies

Child 4

First Name

Last Name

Allergies