University Baptist Church - Baton Rouge, Louisiana

University Baptist Church - Children's Ministry

Vacation Bible School Registration
fields in yellow are required

** Please note, this form allows you to enter up to 6 children from the same family.
Enter the information for the first child at the top and you will be able to enter
the rest of the children's names and information at the bottom of the form. * *

Due to limited space, we can only accept registration from those
who attend University Baptist Church for the 4 year old class.
There are still spaces available for 2,3, and 5 year olds
for both UBC members and members of the community.
Posted 6/10/09

Child's First Name:

Child's Last Name:

Parent/Guardian Names:

Street Address:

Apartment Number:

City:

State:

Zip Code:

Home Phone Number:

Work Phone Number:

Cell Phone Number::

Household Email:

VBS Class Assignment
-
Enter child's birth date: (mm/dd/yyyy)
-
Grade recently completed:
-
T-shirt Size:

Emergency Contacts
-
Name:
-
Phone Number:
-
Name:
-
Phone Number:
-

Dismissal Information

Who may pick up your child at the end of each VBS day?

Other Information

Do you attend church? If so, where?

May we have permission to photograph your child? (required)

Yes No

May we have permission to use your child's photograph in church publications for the purpose of promotion? (required)

Yes No

If you are registering more than one child for Vacation Bible School AND they are members of the same family, please enter the child/children's names below. Otherwise, skip down to the next question.

Child #2
First Name:
Last Name:
Enter child's birth date: (mm/dd/yyyy)
Grade recently completed:
T-Shirt Size:

Child #3
First Name:
Last Name:
Enter child's birth date: (mm/dd/yyyy)
Grade recently completed:
T-Shirt Size:

Child #4
First Name:
Last Name:
Enter child's birth date: (mm/dd/yyyy)
Grade recently completed:
T-Shirt Size:

Child #5
First Name:
Last Name:
Enter child's birth date: (mm/dd/yyyy)
Grade recently completed:
T-Shirt Size:

Child #6
First Name:
Last Name:
Enter child's birth date: (mm/dd/yyyy)
Grade recently completed:
T-Shirt Size:

Please note: Our online registration allows for up to 6 children to be registered on one form. If you have a need to register more than 6 children in the same family, you will need to complete the form a second time and add the rest of the children.

Please use the box below to list any special needs (MEDICAL INFORMATION, FOOD ALLERGIES), comments or concerns regarding your child/children. If you are registering more than one child, please specify which child you are making the comment about.

Please take a moment and review your form
and make sure everything is correct.

Once you have reviewed it, please hit the "Submit Registration" button below and you will be automatically directed to a confirmation page. It may take up to one minute to process. Please hit the button only once, and wait until you receive your confirmation page before exiting the system. Thanks!

University Baptist Church ~ 5775 Highland Road ~ Baton Rouge, Louisiana 70808 ~ Phone: (225) 766-9474