Registration Form

Fill out the form below to register your child for our VBS program

Child's First Name

Child's Last Name

Birthday required

Allergies / Medical Concerns

Parent / Guardian Name

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Phone

Email Address

Name of person authorized to pick up your child?

Name of Emergency Contact

Emergency Contact Phone Number:

Home Church

Any additional information we need to know?

Release of Liability:

I authorize Open Door Baptist Church staff and volunteers to act in the best interest of my child should the need arise and I cannot be reached. I release Open Door Baptist Church, its volunteers, and staff from liability claims, or demands for personal injury, sickness, or death as well as property damage and expenses of any nature that are incurred by my child. I understand that my child will hear a presentation of the gospel and have the opportunity to trust Christ if they so desire.

By electronically signing below and submitting this form, I give my permission for the above named child to participate in all of the activities of Open Door Baptist Church, and I acknowledge my authorization of the above stated release of liability.

Thanks for submitting!