Master Clubs Registration Form
Please fill out this form and click submit.
Child's Information
Name
*
Birthday
*
Age
*
Grade
*
Gender
*
Please select all that apply.
Male
Female
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Parent's Information
Name
*
Phone
*
Medical
Allergies?
Behavioral / Special Needs info?
Pick up
Who may pick up your child/children?
*
Photo/Video Release
By acknowledging below, I give Mountain Highway Baptist Church permission to photograph my child for Master Club purposes. I understand these photos may be used for variious activities, events, social media, promotional materal and church history records.
Your Digital Signature
Date
Submit
Description
Please fill out this form and click submit.
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