Hillsboro Heights Baptist Church
Vacation Bible School 2006
Online Registration Form

Child's Name:
Gender:
If a Preschooler, enter Date of Birth: Month Day Year
If in school, enter last grade completed: Grade

Parent or Guardian's Name:
Email Address:
Home Phone:
Work Phone:
Cell Phone:
Home Address:

Emergency Contact Name:
Emergency Contact Phone:
Who will pick-up the child:
Allergies and other
important Medical
Information:

If you are using an email program like OUTLOOK or EUDORA, click on OUTLOOK to email your registration form,


If you are using an email program like HOTMAIL or YAHOO, click on WEBMAIL. Another window will open with your information that you can then copy into your HOTMAIL email message.


If you need to clear the form and start over, click RESET FORM.