Children need to be age 3 and up and potty trained. Parents & GuardiansParent First & Last Name(Required)Mobile Phone(Required)Email Emergency Contact Name(Required)Mobile Phone(Required)Other adults and phone number authorized to pick up my children:Number of Children:(Required)12345Child 1First & Last Name(Required)Date of Birth(Required)Grade Entering in Fall 2025(Required)Allergies/Special Info:Child 2First & Last Name(Required)Date of Birth(Required)Grade Entering in Fall 2025(Required)Allergies/Special Info:Child 3First & Last Name(Required)Date of Birth(Required)Grade Entering in Fall 2025(Required)Allergies/Special Info:Child 4First & Last Name(Required)Date of Birth(Required)Grade Entering in Fall 2025(Required)Allergies/Special Info:Child 5First & Last Name(Required)Date of Birth(Required)Grade Entering in Fall 2025(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
