Southbury Baptist Church of Southbury CT
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18Dec
Thursday Dec 18th @ 6:30 PM
SHIFT Student Ministry
20Dec
Saturday Dec 20th @ 8:00 AM
Men's Breakfast
21Dec
Sunday Dec 21th @ 9:30 AM
Sunday School
21Dec
Sunday Dec 21th @ 10:30 AM
Worship Service
24Dec
Wednesday Dec 24th @ 5:30 PM
Christmas Eve Service



VBS Registration August 11-15 2014

Parent's Name (*)
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Street Address (*)
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City/State/Zip (*)
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Email Address (*)
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Best Contact Number (xxx) xxx-xxxx (*)
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What church do you attend? (*)
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Name of Emergency Contact (*)
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Relationship to child (*)
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Best Contact Number for Emergency Contact (xxx) xxx-xxxx (*)
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How many children will you be registering for VBS? (*)
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First name of child #1 (*)
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Last name of child #1 (*)
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Date of Birth (mm/dd/yyyy) (*)
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Age of Child (*)
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Grade Entering (*)
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Allergies or special needs we should be aware of? (*)
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First name of child #2
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Last name of child #2
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Date of Birth (mm/dd/yyyy)
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Age of Child
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Grade Entering
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Allergies or special needs we should be aware of?
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First name of child #3
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Last name of child #3
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Date of Birth (mm/dd/yyyy)
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Age of Child
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Grade Entering
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Allergies or special needs we should be aware of?
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First name of child #4
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Last name of child #4
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Date of Birth (mm/dd/yyyy)
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Age of Child
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Grade Entering
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Allergies or special needs we should be aware of?
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First name of child #5
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Last name of child #5
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Date of Birth (mm/dd/yyyy)
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Age of Child
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Grade Entering
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Allergies or special needs we should be aware of?
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If someone other than yourself will be picking up your child/children, please list their name and best contact number (xxx) xxx-xxxx (*)
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I hereby give Southbury Baptist Church the right and permission, with respect to photographs and video taken of my child, or in which my child may be included with others, to use, re-use, publish and re-publish the same in whole or in part, severally or in conjunction with other photographs, in any medium and for any purpose whatsoever including illustration, promotion and advertising. (*)
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Signature (*)
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Address: 114 Roxbury Road. Southbury, CT 06488 | Phone Number: (203) 264-2407
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