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Easton Heights Baptist Church

A Community Church with People at Heart

header photo

VBS Registration Form

Parent/Guardian Name

Emergency Contact Name and Phone #

Alternate Emergency Contact Name and Number

Street Address

Child's Name

Grade Completed

Child's Name

Grade Completed

Child's Name

Grade Completed

Child's Name

Grade Completed

If your child has special needs list them here - Medical/Allergies etc.

Names of those who have permission to pick up your child *

* We take your child's safety seriously. As a result, for the protection of your child and other children in our care, a photo ID will be required to pick up a child from VBS. Thank you for understanding.

If You Are not a Member of EHBC, Do You Have a Church Home?

May we have permission to use a photograph or video of your child to create an end of VBS video presentation?

Yes

No

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