Colonial Hills Baptist Church

How many children will you be registering for CHBC's Summer Bible Club (every Saturday in June from 10 to 11:30 AM)? *

Parent's/Guardian's Name: *

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Last

Parent's/Guardian's Address (line 1): *

Parent's/Guardian's Address (line 2):

City: *

State: *

Zip: *

Parent's/Guardian's Phone Number: *

Parent's/Guardian's Email: *

Emergency Contact Name: *

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Emergency Contact Phone Number: *

Child's/Children's Relationship to Emergency Contact: *

Home Church: