REGISTRATION

Registration

Participant

* Indicates required field

Name of Child *

First

Last

Gender *

Boy Girl

Age (must be between this age range) *

Emergency contact

Parent's / Guardian's name *

First

Last

Phone Number *

Address (Optional) *

Line 1

Line 2

City

State

Zip Code

Country

I authorize for Cleburne First VBS photographer or videographer to take pictures or videos of my child, which may be used in the church's social media. *

Yes No

Submit