Children’s Ministry Registration
Please fill out this form and click submit.
Child’s Name
*
Current Grade
*
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Not yet in PreK
PreK
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Child’s Birthday
*
Select which applies to your child
*
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Male
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Parent/Guardian Name
*
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
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NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
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NY
OH
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ON
OR
PA
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PR
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QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
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YT
Phone
*
Email
*
This address will receive a confirmation email
Emergency Contact Name and Number
*
List authorized people to pick up your child
*
List any allergies
*
List any additional information you want us to know about your child
*I understand by signing this form that all the information provided is accurate to the best of my ability. I also waive and release all claims against First Baptist Church of Lebanon Junction (FBCLJ), with respect to any injury or illness on church property. *I give First Baptist Church of Lebanon Junction (FBCLJ) permission to use and publish photograph(s) of my child(ren), whether in print or electronic media when in conjunction with Children’s Ministry and church activities. *I understand that FBCLJ has a zero tolerance for bullying and violence. By allowing my child(ren) to participate in activities at FBCLJ, my child(ren) is expected to follow the rules. Failure to follow rules will result in the expectation that I must pick up my child from the FBCLJ activity. *I understand that I will withhold participation for my child(ren) if they are sick – including illnesses that are contagious and if they had a fever within the last 24 hours. I understand that if my child(ren) become ill during FBCLJ activities that it is the expectation that I will pick my child(ren) up from the activity. *I understand that if the person(s) eligible to pick up my child changes, I must contact the Children's Ministry Director of First Baptist Church Lebanon Junction immediately to inform them on the changes. Communication to change the eligible pick-up person(s) must be in written form.
*
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I agree
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I agree
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