106 Grand Ave NW
Fort Payne, AL 35967-2032
256-845-2015

Missions

VBS Registration Form

Last Grade Completed (required)
Child's Name
Parent / Guardian Name

Physical Address
Street/Road
City
State
Zip
Mailing Address (if different)

Phone Numbers
Home
Work
Cell

Email Address

Age Information
Birth Date (e.g. YYYY-MM-DD)

Medical Information
Medical or other information that we need to know (Include food allergies)

Emergency Contacts
Name Number
Name Number

Other Information

Do you attend Sunday School? Yes @ FBCYesNo

If yes where?

If you are visiting our church, who are you a guest of?

Are you a Christian? YesNo

Member of any Church? Yes @ FBCYesNo

Name of Church City

May we have permission to photograph you child? YesNo

May we have permission to use your child's photograph for use by F.B.C. for us on our website, presentations, bulletin boards, other electronic media, ect? YesNo

If you answered yes to the two questions above, please click agree below, if you are the legal guardian:
I hereby agree to allow my child to be photographed and give permission to F.B.C to use my child's photograph.

Transportation Information

If your child is being transported by First Baptist Church, please choose only one of the following pickup locations:
Ramblewood apartment ComplexSequoyah Trailer ParkWills Valley Trailer Park

A copy of the completed for will be emailed to you, as well as the First Baptist Church.
Thank you,