Children’s Registration – Grace Baptist Church

Please fill out and submit the following form to help us keep up to date records.

Grace Baptist Church Children's Registration

Nursery through School age

Date:

Parents Name:(Required)

Dad Mom Last

Home Phone:(Required)

Dad's Cell (if available )

Mom's Cell (if available)

Email (whomever is most likely to respond)

Child/Children's Information

Child's Name(Required)

First Last

Date of Birth(Required)

Grade and School

Grade School

Child's Name

First Last

Date of Birth

Grade and School

Grade School

Child's Name

First Last

Date of Birth

Grade and School

Grade School

Allergies and Special Concerns

Please indicate allergies and reactions. Feel free to list any behavioral concerns as well.

Additional information we may need:

Please inform us of any custody issues, no contact, guardianship, etc.