Arlington Baptist Church
Saturday, November 18, 2017
 
Name
 
Date of Birth       Age
 
 Siblings attending? Please list names and ages below:
 
Parent/Guardian
 
Address
 
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