ABC Registration

First Name

Last Name

Grade

Birthdate

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Allergies

Parents First Name

Parents Last Name

Email

Phone Number

Permission to us images and video.

I herby grant Hilltop Church to record sounds, images, or video of my child while attending Adventure Bible Club (ABC). I also give permission for Hilltop Church at its sole discretion, to use these sounds, images, or videos in publications (including print, websites, and social media platforms) owned by Hilltop Church in relation to Adventure Bible Club (ABC).

Yes

No

Signature

Date Input