Antioch Baptist Church
About Us
Upcoming Events
Commit - Discipleship Helps
Recent Photos
About Us
Upcoming Events
Commit - Discipleship Helps
Recent Photos
Antioch Baptist Church
For God's Glory & Our Joy
VBS Registration
Child's Name
*
Child's Name
First Name
Last Name
Date of Birth
Date of Birth
MM
DD
YYYY
Mother's/Guardian's Name
*
Mother's/Guardian's Name
First Name
Last Name
Father's Name
Father's Name
First Name
Last Name
Home Street Address
*
Home Street Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
Phone
(###)
###
####
Email Address
*
Allergies
*
If your child has food or drug allergies that our staff should know about please check yes and list allergies below
Yes
No
Home Church
Thank you for letting us serve your child! Game On!