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Information Form
Child's Name
*
First
Last
Child's Birthdate
*
Parent's Name
*
First
Last
Address
*
Mom's Phone Number
*
Dad's Phone Number
*
Name and phone number of the person who brings this child to church (if someone other than parent)
*
Medical or other information we need to know: (Please include any food allergies):
*
Who may pick up your child?
Name
*
First
Last
Phone Number
*
Name
*
First
Last
Phone Number
*
My K-3rd Grade child may be released on his/her own when class is over.
*
Yes
No
Submit
First Baptist Church
1006 Hillsboro Blvd.
Manchester, TN
Wee Connect
Kids Connect