TODAY'S HOUR: ______________ TODAY'S CAMPUS: ______________

REGULAR ATTENDEE: ____

Please print

If not parents, responsible adults' names: _________________________________

CHILD'S NAME (Please include last

name if different from parent.)M/F

DATE OF

BIRTHAGE GRADE

HOUR/CLASS

ASSIGNED

___________________________ _____ __________ ___ ____ _______________

___________________________ _____ __________ ___ ____ _______________

___________________________ _____ __________ ___ ____ _______________

___________________________ _____ __________ ___ ____ _______________

____________________________________________________

ADULT SIGNATURE

I’M INTERESTED IN SERVING (Please check all that apply):

Saturday Evening _____

Sunday Morning _____

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

Wednesday Evening _____

Preferred Age: Nur. Tod. 2's 3's 4's K's Elem. (Please circle one)

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."

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

Special Needs ______

PARENTS' NAMES (First & Last) _________________________________

In order to best meet the needs of children, please check all

boxes that indicate areas we need to be aware of.

Children's Ministry Weekend Registration 2014/2015

Nursery - 4th Grades

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.

TODAY'S DATE: _________________

VISITOR: ____

How did you hear about FBCG:

Friend ____ Church Ministry ____ Website ____ Drive By ____ Other ____ Invited by: __________________

PREFERRED PHONE: _________________________________________ EMAIL: __________________________________________________________

We offer support for children with special needs. Would this be helpful for your child? _____ Yes _____ No

Allergies/Medical Developmental Emotional Behavioral Academic Physical

ADDRESS: __________________________________________________ CITY: _________________________________ ZIP: __________________

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