Parents & GuardiansFirst & Last Name(Required)Mobile Phone(Required)First & Last NameMobile PhoneOther adults authorized to pick up my children:Number of Children:(Required)12345Child 1First & Last Name(Required)Date of Birth(Required)Allergies/Special Info:Child 2First & Last Name(Required)Date of Birth(Required)Allergies/Special Info:Child 3First & Last Name(Required)Date of Birth(Required)Allergies/Special Info:Child 4First & Last Name(Required)Date of Birth(Required)Allergies/Special Info:Child 5First & Last Name(Required)Date of Birth(Required)Allergies/Special Info:AuthorizationsMedical Consent(Required) I AgreeBy submitting this form, I give permission for my child to receive emergency medical care. I will not hold First Baptist Church of Jefferson City, TN responsible for any expense or liability arising from an injury to my child.Photos(Required)I give permission for my child to be photographed and/or videoed with the understanding that the footage might be used on social media, bulletin boards, the church website, etc. Yes No Snacks(Required)Snacks are sometimes offered during Sunday School and/or Extended Teaching Care. I give permission for my child to eat these snacks (which will be checked for allergens prior to serving). Yes No
