VBS Registration | Romulus Baptist Church

Name of child (First and Last name) (Required)

Age of child (Required)

Gender (Required)

Birthdate (Required)

Last Grade Completed (Required)

Allergies, Medication, or Medical Conditions (Required)

Mother's Name (First and Last name)

Custodial Parent (Required)

Yes

Mother's Cell Phone

Mother's Email

Mother's Address

Father's Name (First and Last name)

Custodial Parent (Required)

Yes

Father's Cell Phone

Father's Email

Father's Address

Emergency Contact Info (others than listed) (Required)

Name of people authorized to pick up child(ren) (Required)

Solve 1 + 9 = ?

Romulus Baptist Church