VBS Preregistration Form

Vacation Bible School at South Harriman Baptist Church is June 10 - 14 from 5:30pm to 8:00 pm for children aged 3 years old through those who have just completed the 6th grade.

Please fill out and submit this form to preregister your child for Vacation Bible School. On the first day of VBS, your child's information will already be in our system, and you'll be able to check your child in a matter of seconds instead of waiting to fill out paperwork. 

Fields marked with an asterisk must be filled out.

Child's Name *
Child's Name
Parent/Guardian Name *
Parent/Guardian Name
Address *
Cell Phone Number *
Cell Phone Number
Please provide at least one reliable phone number you can be reached at. Addition phone numbers can be added below.
Home Phone Number
Home Phone Number
Child's Birthdate *
Child's Birthdate
Medical or other information we may need to know. (Please Include Any Food Allergies)
Please list at least one emergency contact.
Emergency Contact Phone Number *
Emergency Contact Phone Number
If you would like your child to ride the church van/bus please confirm your home is within five miles of the church.
Please confirm your home is within 5 miles of South Harriman Baptist Church
Only for SHBC van/bus riders.
Would you like to stay updated with the various ministries and Children's Programs at South Harriman? *
Photo Release *
I give South Harriman Baptist Church permission for photos of my child to appear in SHBC publications and media. I also give my permission for photos of my child to appear among other general VBS photos that will not contain identifying information.