Arlington Baptist Church
Saturday, November 18, 2017
Date of Birth      Current Grade     Age
 Siblings attending? Please list names and ages below:
City State      Zip
Home Phone      Cell Phone
Do you accept text messages?     YES     NO
E-Mail Address
Emergency Contact Name and Number
Special Needs/Allergies/Other Concerns
Is there a friend your child would like to be place with?
PHOTO RELEASE: By filling out this form I also agree to the following release of information regarding my child: The church may feature my child in the broadcast and print media, on the church web site, and in publications and programs.
Parent Signature      Date