Cedar Hill Baptist VBS
Email address *
Student Information
Student name *
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Student birthday *
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Student age *
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Last grade completed *
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Street address *
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City *
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Parent/ Guardian Information
Parent/Guardian name *
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Parent/Guardian phone number *
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Does your family regularly attend church
Name of church
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Emergency Contact Information
Emeregency Contact #1 name & number *
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Emergency Contact #2 name & number *
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I give permission for my child to be photographed or videotaped as part of Cedar Hill Baptist activities. *
Other information (allergies, special needs, or special instructions).
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