Mission Rescue Holiday Bible Club

Online Registration Form

Child's Name:

Date of Birth (dd/mm/yyyy):

Address:

Parent/Guardian 1 Name:

Parent/Guardian 1 Contact Number:

Parent/Guardian 1 Email Address:

(So we can let you know about future events.)

Parent/Guardian 2 Name:

Parent/Guardian 2 Contact Number:

Details of any Medical Conditions or Alergies:

Is it ok if we take photos and display them within the church or on the church website?:* (required)

Yes
No

Security verification, please type what you see in the box above.* (required)

The Word for Today 22 Feb 2012 'YOUR HABITS DETERMINE YOUR FUTURE' 22 February 2012
'...Three times a day he got down on his knees and prayed...' Daniel 6:10 […]