Registration

Please fill out one registration form per child. Thank You.

First Name

Last Name

Gender

Birthdate

Phone Number

Address 1

Address 2

City

State

Zip/Postal Code

Email

Home Church

Allergies/Medical Conditions

Emergency Contact Info

Relationship to Child

First Name

Last Name

Emergency Contact Phone Number

Permission to use images and video

I hereby grant permission for Hilltop Church to record sounds, images, or video of my child while attending Bible Bootcamp VBS. I also give permission to 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 Bible Bootcamp VBS.

Permission to use images and video
Yes
No

Initials

Today's Date