Colonial Hills Baptist Church

Parent's Name: *

First

Last

Parent's Address (line 1): *

Parent's Address (line 2):

City: *

State: *

Zip: *

Parent's Phone Number: *

Parent's Email:

Name of person authorized to pick up child/children: *

First

Last

Emergency contact name: *

First

Last

Emergency contact phone number: *

Child's/children's relationship to emergency contact: *

Home Church

Child:

Child's Name: *

First

Last

Child's Gender: *

Male
Female

Please select the events your child has attended at Colonial Hills Baptist Church:

Which Saturdays in June will your child be attending Summer Bible Club? *

All Saturdays in June
Saturday, June 6th
Saturday, June 13th
Saturday, June 20th
Saturday, June 27th
Don’t know yet.

Child's age as of June 6, 2026: *

Child's school grade in the fall of 2026: *

What size t-shirt (Gildan brand, 50/50 blend) does your child wear? *

Child's Allergies: *

Please list any allergies or put “none” if your child does not have allergies.

Child's Medical Conditions: *

Please list any medical conditions your child has, or put “none” if your child does not have any medical conditions.

Do you have a second child to register? *

Second Child:

Second Child's Name: *

First

Last

Second Child's Gender: *

Male
Female

Please select the events your second child has attended at Colonial Hills Baptist Church:

Which Saturdays in June will your second child be attending Summer Bible Club? *

All Saturdays in June
Saturday, June 6th
Saturday, June 13th
Saturday, June 20th
Saturday, June 27th
Don’t know yet

Second Child's age as of June 6, 2026: *

Second Child's school grade in the fall of 2026: *

What size t-shirt (Gildan brand, 50/50 blend) does your second child wear? *

Second Child's Allergies *

Please list any allergies or put “none” if your child does not have allergies.

Second Child's Medical Conditions: *

Please list any medical conditions your child has, or put “none” if your child does not have any medical conditions.

Do you have a third child to register? *

Third Child:

Third Child's Name *

First

Last

Third Child's Gender: *

Male
Female

Please select the events your third child has attended at Colonial Hills Baptist Church:

Which Saturdays in June will your third child be attending Summer Bible Club? *

All Saturdays in June
Saturday, June 6th
Saturday, June 13th
Saturday, June 20th
Saturday, June 27th
Don’t know yet.

Third Child's age as of June 6, 2026: *

Third child's school grade in the fall of 2026: *

What size t-shirt (Gildan brand, 50/50 blend) does your third child wear? *

Third Child's Allergies: *

Please list any allergies or put “none” if your child does not have allergies.

Third Child's Medical Conditions: *

Please list any medical conditions your child has, or put “none” if your child does not have any medical conditions.

Do You have a fourth child to register? *

Fourth Child:

Fourth Child's Name *

First

Last

Fourth Child's Gender: *

Male
Female

Please select the events that your fourth child has attended at Colonial Hills Baptist Church:

Which Saturdays in June will your fourth child be attending Summer Bible Club? *

All Saturdays in June
Saturday, June 6th
Saturday, June 13th
Saturday, June 20th
Saturday, June 27th
Don’t know yet.

Fourth child's age as of June 6, 2026: *

Fourth child's school grade in the fall of 2026: *

Which Saturdays will your fourth child be attending Summer Bible Club? *

What size t-shirt (Gildan brand, 50/50 blend) does your fourth child wear? *

Fourth Child's Allergies: *

Please list any allergies or put “none” if your child does not have allergies.

Fourth Child's Medical Conditions: *

Please list any medical conditions your child has, or put “none” if your child does not have any medical conditions.