Vacation Bible School Registration 2019
Into the Wild: Amazing Encounters with Jesus
VBS: July 8-12 @ 8:30 am - 11:30 am
Email address *
Child's Information:
Name: *
Date of Birth: *
Last Grade Completed in School *
T-Shirt Size *
Parent/ Guardian Information:
Name: *
Phone number *
Email *
Address *
Medical Information:
Medical or Other Information We Need to Know
Additional Information:
Emergency Contact Information
Please list a secondary contact person other than the one stated above
Name & Relationship *
Phone Number
Pick-Up Information
Who will be picking your child up at the conclusion of VBS each day?
Name & Relationship: *
Phone Number *
Other Information:
Do you attend a church in the area? *
If no, would you like to receive additional information about Antioch Baptist Church?
How did you hear about Antioch Baptist Church? *
May We Have Permission to Photograph Your Child? *
May We Have Permission To Use Your Child's Photograph For The Purpose Of Promotion? (i.e. Facebook, Instagram, Website) *
We have a special guest attending our VBS on Thursday, July 11
Dan the Animal Man will be bringing wild life animals and doing a Gospel Presentation @ 10 am in the Fellowship Hall. You are welcome to join us on that day.
Any Questions?
Contact VBS Director Chase Greeson


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