We look forward to enjoying our Vacation Bible School together with you. To help us prepare for this event, we ask that you complete the short form below. This will enable us to have adequate resources available to ensure an enjoyable and profitable time for your children.

Very Important - every field with a "*" next to it is a REQUIRED field and something must be in it in order for a successful registration. You should see at the top of the screen "Registration Received!" after clicking on the Submit Registration if everything was entered, otherwise you will see an error message and need to fill the form in again.

Child's Name: * [First and Last]
Age: *
Grade: *  [Last Grade Completed]
Address: *
City: *  
State: *  
Zip: *
Phone: *  [Format: (xxx) xxx-xxxx]
Email:  [if available]
Parent/Guardian: *
Emergency Contact: *
Phone #: *  [Format: (xxx) xxx-xxxx]
Who is authorized to pick up your child? *
Attend Holly Hills: * Yes No
Attend Another Church: * Yes No
Invited By:  [leave blank if self]
By submitting this online registration you acknowledge the following:
While on the property of Holly Hills Baptist Church and during the course of our VBS program: In case of accident or emergency, I, the parent or guardian of the above named child, give my consent for any licensed physician, dentist or emergency personnel to administer treatment deemed necessary prior to my arrival.
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