FRBC Children's Ministry Registration

Please fill out this form, one per child, and click submit. Thank you for registering your children!

Child Information

Child Name

*

Birthday

*

Age/Grade

*

Please select one option.

Nursery (Birth-2 Year Old) 3 Years Old 4 Years Old 5 Years Old Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade

Address

*

Gender

*

Please select all that apply.

Male Female

Please list all known allergies

*

Parent/Guardian Information

1st Parent/Guardian Full Name

*

1st Parent/Guardian Relationship to Child

*

Please select all that apply.

Mother Father Grandparent Other

1st Parent/Guardian Cell Phone

*

1st Parent/Guardian Email

*

This address will receive a confirmation email

1st Parent/Guardian Address if different from child

Secondary Parent/Guardian Full Name

2nd Parent/Guardian Relationship to Child

Please select all that apply.

Mother Father Grandparent

2nd Parent/Guardian Cell Phone

2nd Parent/Guardian Email

Description

Please fill out this form, one per child, and click submit. Thank you for registering your children!

Please Fix the Following

Close