Vacation Bible School (2021-06-14)

June 14, 2021 @ 5:30 pm – June 16, 2021 @ 8:00 pm

2021-06-14T17:30:00-05:00

2021-06-16T20:00:00-05:00

Cross Roads Baptist Church
181 West Beaverdam Rd. Centerville
Tn 37033

Myleah McGuigan

9316980520

Name
First Last
Gender
Birth Date

(M/D/Y)
Age
Grade Completed
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Parent/Guardian
First Last
Phone
Email
Emergency contact & contact info
Emergency contact's relationship to child
Who is authorized to pick up your child?
Name of home church
Allergies/Medical concerns
PERMISSION TO USE IMAGES AND VIDEO
I hereby grant permission for Cross Roads Baptist Church to record sounds, images, or video of my child
- Yes
- No
I also give permission for Cross Roads Baptist Church, at it's sole discretion, to use these sounds, images, or videos in publications (church website/social media platforms owned by the church).
- Yes
- No
- n/a
Parent/Guardian digital signature & date
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PERMISSION TO USE IMAGES AND VIDEO