Children's Ministry Registration Form — First Baptist Church

Please register each of your children using the form below. Thank you!

Child's Name

First Name

Last Name

Address (Street, City, Zip)

Child's Birth Date

MM

DD

YYYY

Mom's Name

Mom's Cell Phone

(###)

###

####

Dad's Name

Dad's Cell Phone

(###)

###

####

Preferred Email Address

Home Phone

(###)

###

####

Siblings (with ages)

Who may pick up your child from class?

Allergies:

Special Instructions or helpful information: