FBCKids Registration Form Children's Ministry Registration Please fill out this form prior to your child's attendance Guardian InformationYour Name* First Last Spouse's Name First Last If applicableYour relationship to the child* Parent Grandparent Aunt / Uncle Phone*Email* Address* Street Address City ZIP / Postal Code List of individuals allowed to pick-up your child(ren)*Child(ren) InformationChild's Name* First Last Date of Birth* Month Day Year Grade Level*Infant / Baby (0-2)Toddler / Pre-K (older 2s-4s)Elementary Age (Kinder-6th)Photo of Childfor help in identifying childMax. file size: 2 GB.Do you need to add another child?* Yes No Child 2's Name* First Last Child 2's Date of Birth* Month Day Year Child 2's Grade Level*Infant / Baby (0-2)Toddler / Pre-K (older 2s-4s)Elementary Age (Kinder-6th)Photo of Child 2for help in identifying childMax. file size: 2 GB.Do you need to add a 3rd child?* Yes No Child 3's Name* First Last Child 3's Date of Birth* Month Day Year Child 3's Grade Level*Infant / Baby (0-2)Toddler / Pre-K (older 2s-4s)Elementary Age (Kinder-6th)Photo of Child 3for help in identifying childMax. file size: 2 GB.Do you need to add a 4th child?* Yes No Child 4's Name* First Last Child 4's Date of Birth* Month Day Year Child 4's Grade Level*Infant / Baby (0-2)Toddler / Pre-K (older 2s-4s)Elementary Age (Kinder-6th)Photo of Child 4for help in identifying childMax. file size: 2 GB.Do you need to add a 5th child?* Yes No Child 5's Name* First Last Child 5's Date of Birth* Month Day Year Child 5's Grade Level*Infant / Baby (0-2)Toddler / Pre-K (older 2s-4s)Elementary Age (Kinder-6th)Photo of Child 5for help in identifying childMax. file size: 2 GB.Do you need to add a 6th child?* Yes No Child 6's Name* First Last Child 6's Date of Birth* Month Day Year Child 6's Grade Level*Infant / Baby (0-2)Toddler / Pre-K (older 2s-4s)Elementary Age (Kinder-6th)Photo of Child 6for help in identifying childMax. file size: 2 GB.Please list any allergies or special considerations we should be aware of for your child(ren)*If not applicable, please write NA in the boxUpload Family PhotoPlease upload a family photo to help us in identifying pick-up privileges.Max. file size: 2 GB.EmailThis field is for validation purposes and should be left unchanged. Δ
