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
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_____ 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
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Preferred Age: Nur.
Tod.
2's
3's
4's
K's
Elem.
Sunday Morning
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Special Needs ______
Elevate
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Misc. Assistance: (Such as administrative, sewing, painting, bulletin boards, etc.) ________________
Wednesday Evening
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Would like to be involved, but am not sure how or where. Please contact me _____
(Please circle one)