VBS Registration | Falling Water Baptist Church

First Name:

Last Name:

Address:

Phone:

Alternate Phone:

Email:

Emergency Contact Name:

Emergency Contact Phone #

Child Date of Birth

Age:

Grade last completed:

Enrolled in Sunday School?

If `yes`, where?

Parents Name:

Special Needs (allergies/medical info)

May we have permission to photograph your child?

May we have permission to use your child's photograph for the purpose of promotion?

Who may pick up child?

New Field:

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Service Times

Address

523 Roberts Mill Road

Hixson, TN 37343

Phone

423-842-5924

Email

fwbcoffice@gmail.com

Office Hours

Monday – Thursday

9:00 a.m. to 2:00 p.m.

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