Kids 'n Christ/FBC Students Registration

Please complete all fields to register your child or student for their Wednesday night ministry.

Child/ Student Name(Required)

First Last

Birth Date(Required)

Current Grade(Required)

Phone Number(Required)

Address(Required)

Medical/Allergies/Important Information(Required)

Emergency Contact Name & Phone Number(Required)

Arrival/Dismissal Procedure(Required)

My child/student needs to be picked up by the church van.

My child/student needs to ride home on the church van.

My child will be dropped off and picked up at the church.

Dropped off/Picked Up By:(Required)

If your child/student does not need to be picked up/brought home on the church van, please indicate who will be dropping off and picking up the child/student from the church.

Name

This field is for validation purposes and should be left unchanged.