2019 Backyard Bible Club Registration
The Summer Bible Club for Kids!
All clubs begin the week of June24 and end by August 9.
www.BackyardBibleClubs.blogspot.com
Email address *
Parent's Name(s) *
Your answer
Street Address *
Your answer
City, State, Zip *
Your answer
Phone Number *
Your answer
Emergency Contact *
Your answer
Emergency Phone Number *
Your answer
1. Child's Name *
Your answer
1. Child's Birthday *
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DD
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YYYY
1. Child's Allergies
2. Child's Name
Your answer
2. Child's Birthday
MM
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DD
/
YYYY
2. Child's Allergies
3. Child's Name
Your answer
3. Child's Birthday
MM
/
DD
/
YYYY
3. Child's Allergies
4. Child's Name
Your answer
4. Child's Birthday
MM
/
DD
/
YYYY
4. Child's Allergies
List Home Church (if any)
Your answer
Do you grant permission for Backyard Bible Clubs to use pictures/videos of your child/children on their website for informational/ and promotional purposes? *
Mark the club location your child/children will be attending. *
Required
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