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Rolling Hills Baptist
5742 Pleasant Ave.
Fairfield, OH 45014

Phone:
513-829-3725
Fax:
513-829-4851

 
 

 
 

Senior Pastor:
Danny Rollins

Minister of Students:
Steven Staton

Minister of Worship
Dan Prior

 
     
   
 
 
Pre-Registration Form
Child's Name
 Age:
 Grade:
 Birth Date:
Child's Name
 Age:
 Grade:
 Birth Date:
Child's Name
 Age:
 Grade:
 Birth Date:
Address:
City
 State
 Zip
  
Person the child lives with

How did you hear about DC4K?
If you plan on bringing children to our child care (available for children younger than kindergarten age), please list their names and ages below.
Child's Name
 Age:
    
Child's Name
 Age:
    
Child's Name
 Age:
    
 
 

 

  
  Please Note: Space is limited. This registration will hold a place for your child(ren) in the DC4K seminar. On the first day of the seminar, we will need your signature and your payment of $12/child and $10/additional child.