Campbellford Baptist Church

Campbellford Baptist Church - VBS 2019

• Child's Name*
  First Name

  Last Name
• Child's Gender*
  >MF
• Date of Birth*
  MM

  /

  DD

  /

  YYYY
• Last School Grade Completed*
  >JKSK123456
• Child's Age*
• Name of Parents*
  First Name

  Last Name
• Street Address*
• City / Town - Prov. - Postal Code*
• Home Phone*
   
• Parent/Caregivers Cell Phone
   
• Your Email
   
• Home Church
• Approval to display/publish photo(s)*
  Yes

  No
• Alergies or other medical conditions
• In Case of emergency, contact
  First Name

  Last Name
• Phone
   
• Relationship to child
• One friend you would like in your crew if possible
• Crew number or name (Church Use Only)