2014 2015 Family Registration Card

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Children's Ministry Weekend Registration 2014/2015 Nursery - 4th Grades

TODAY'S DATE: _________________ REGULAR ATTENDEE: ____

TODAY'S HOUR: ______________

TODAY'S CAMPUS: ______________

VISITOR: ____ How did you hear about FBCG: Friend ____ Church Ministry ____

Website ____

Drive By ____

Other ____

Invited by: __________________

Please print

PARENTS' NAMES (First & Last) _________________________________

If not parents, responsible adults' names:

ADDRESS: __________________________________________________

CITY: _________________________________

PREFERRED PHONE: _________________________________________

EMAIL: __________________________________________________________

CHILD'S NAME (Please include last name if different from parent.)

M/F

DATE OF BIRTH

AGE

GRADE

_________________________________ ZIP: __________________

In order to best meet the needs of children, please check all boxes that indicate areas we need to be aware of. Allergies/Medical

Developmental

Emotional

Behavioral

Academic

HOUR/CLASS ASSIGNED

Physical

]

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We offer support for children with special needs. Would this be helpful for your child? _____ Yes

_______________

_____ No

I hereby consent to the use of any videotapes, photographs, slides, audiotapes, or any other visual or audio reproduction of FBCG in which my children appear. I understand that these materials may be used for promotion of Children's Ministries of FBCG. I release FBCG from any liability connected with the use of my children's pictures or voice recording as part of any promotion or recruitment.

____________________________________________________ ADULT SIGNATURE

CHILDREN'S MINISTRIES invites & encourages you to be a part of changing and impacting the lives of children. PLEASE consider what role you might play in "Loving Children to Jesus." I’M INTERESTED IN SERVING (Please check all that apply): Saturday Evening

_____

Preferred Age: Nur.

Tod.

2's

3's

4's

K's

Elem.

Sunday Morning

_____

Special Needs ______

Elevate

_____

Misc. Assistance: (Such as administrative, sewing, painting, bulletin boards, etc.) ________________

Wednesday Evening

_____

Would like to be involved, but am not sure how or where. Please contact me _____

(Please circle one)


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