VBS

VBS 2024

July 15 - 19

8:00 a.m. - 12:00 noon

(Early drop off is 7:30 a.m.)

All children are welcome!

Completed Pre-K4 through 6th Grade
Optional - T-shirts $10 - Music CD's $3

VBS Registration Form

Register for VBS using the form below.
Space is provided for 3 children. If you need to register more than 3, please send this and then complete another.

Items marked with * are required.

Parent's Names*

Please type your full name.

Your E-mail*

Please enter a valid email address.

Street Address*

Please enter your street address.

City, State, Zip*

Please enter your city, state, and zip.

Your Phone(s)*

Please enter at least one phone number.

Who may pick up
these children?*

This field is required.

Photo Permissions*

YesNo

Field is required. Please select Yes or No.

I give permission for my child(ren) to be photographed and for their pictures to be used by Highland Baptist Church as desired.
(If you do no want your child photographed, please inform them.)

Where did you
hear about us?

Invalid Input

Do you regularly attend church?*

YesNo

Field is required. Please select Yes or No.

If so, where?*

Invalid Input

CHILD 1 INFORMATION

Name*

At least one child's name is required.

Birthdate*

/ / A birth date is required.

Gender*

Gender is required

Grade Completed*

School grade completed is required.

Special Needs

Invalid Input

Enter any diet restrictions, health concerns or behavioral issues we should know about.

If you would like to purchase a T-shirt, please select a size. We will try to have one available the first day of VBS.

T-shirt Size

Invalid Input

CHILD 2 INFORMATION

Name

Invalid Input

Birthdate

/ / Invalid Input

Gender

Gender is required

Grade Completed

Invalid Input

Special Needs

Invalid Input

Enter any diet restrictions, health concerns or behavioral issues we should know about.

If you would like to purchase a T-shrit, please select a size. We will try to have one available the first day of VBS.

T-shirt Size

Invalid Input

CHILD 3 INFORMATION

Name

Invalid Input

Birthdate

/ / Invalid Input

Gender

Gender is required

Grade Completed

Invalid Input

Special Needs

Invalid Input

Enter any diet restrictions, health concerns or behavioral issues we should know about.

If you would like to purchase a T-shrit, please select a size. We will try to have one available the first day of VBS.

T-shirt Size

Invalid Input

Disclaimer*

I understand that this message will be sent by unsecured email.
I will not hold Highland Baptist Church responsible should it be intercepted and used by any unintended party.
I understand that no information that is private or confidential should be sent using this form.

Item must be checked to send.

Please enter these characters.*

Refresh Characters do not match. Please try again. Case sensitive.

Click to Send

	Phone - 318-396-1271 Fax - 318-396-4838 (call before faxing)
	Highland Baptist Church 1509 Arkansas Road West Monroe, LA 71291
	Office Hours Mo-Th, 8:30-4:00; Fr, 8:30-12:00 (Closed 12-1 for lunch) Office Is in West End of 2-Story Building
	Click to Send an Email To email staff, see 'About Us'

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