Southbury Baptist Church of Southbury CT
Prayer Requests | Times & Directions | Contact Us
 

26Oct
Sunday Oct 26th @ 9:30 AM
Sunday School
26Oct
Sunday Oct 26th @ 10:30 AM
Worship Service
30Oct
Thursday Oct 30th @ 6:30 PM
SHIFT
02Nov
Sunday Nov 2th @ 9:30 AM
Sunday School
02Nov
Sunday Nov 2th @ 10:30 AM
Worship Service



VBS Registration August 11-15 2014

Parent's Name (*)
Invalid Input
Street Address (*)
Invalid Input
City/State/Zip (*)
Invalid Input
Email Address (*)
Invalid Input
Best Contact Number (xxx) xxx-xxxx (*)
Invalid Input
What church do you attend? (*)
Invalid Input
Name of Emergency Contact (*)
Invalid Input
Relationship to child (*)
Invalid Input
Best Contact Number for Emergency Contact (xxx) xxx-xxxx (*)
Invalid Input
How many children will you be registering for VBS? (*)
Invalid Input

First name of child #1 (*)
Invalid Input
Last name of child #1 (*)
Invalid Input
Date of Birth (mm/dd/yyyy) (*)
Invalid Input
Age of Child (*)
Invalid Input
Grade Entering (*)
Invalid Input
Allergies or special needs we should be aware of? (*)
Invalid Input

First name of child #2
Invalid Input
Last name of child #2
Invalid Input
Date of Birth (mm/dd/yyyy)
Invalid Input
Age of Child
Invalid Input
Grade Entering
Invalid Input
Allergies or special needs we should be aware of?
Invalid Input

First name of child #3
Invalid Input
Last name of child #3
Invalid Input
Date of Birth (mm/dd/yyyy)
Invalid Input
Age of Child
Invalid Input
Grade Entering
Invalid Input
Allergies or special needs we should be aware of?
Invalid Input

First name of child #4
Invalid Input
Last name of child #4
Invalid Input
Date of Birth (mm/dd/yyyy)
Invalid Input
Age of Child
Invalid Input
Grade Entering
Invalid Input
Allergies or special needs we should be aware of?
Invalid Input

First name of child #5
Invalid Input
Last name of child #5
Invalid Input
Date of Birth (mm/dd/yyyy)
Invalid Input
Age of Child
Invalid Input
Grade Entering
Invalid Input
Allergies or special needs we should be aware of?
Invalid Input

If someone other than yourself will be picking up your child/children, please list their name and best contact number (xxx) xxx-xxxx (*)
Invalid Input

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. (*)
Invalid Input

Signature (*)
Invalid Input

 

 
 
Home | Times & Directions | Listen Online | Give Online | Sitemap | Contact Us
Address: 114 Roxbury Road. Southbury, CT 06488 | Phone Number: (203) 264-2407
Site Design By Mychurchwebsite.com