Registration

Completing this registration form will add you to our secure "Haven Baptist Church" database, and this will help our church stay connected.

Contact Information

First Name *

Last Name *

Email Address *

Phone Number

Mobile Number *

Mailing Address *

Mailing City *

Mailing State *

Mailing Postcode *

Gender *

Registering Adult or Child? *

Date of Birth *

School Grade *

Alerts

Medical/Allergies

Authorisation

Photography

We would like to use photos of your child(ren) in our church publications or church video, our website, and Facebook pages. Names would not be used to identify the child(ren). Please choose authorisation.

Photography