Child's First Name* Child's Last Name* Birthday* Last Grade Completed 4 yr. old PreK Kinder 1st 2nd 3rd 4th 5th 6th * Street Address* City* State* Zip*
Parent/ Guardian Name* Phone Number* Email Street Address* City* State* Zip*
Parent/ Guardian Name Phone Number Email Street Address City State Zip
Emergency Contact * Phone Number* Please Select Parent Grandparent Aunt/Uncle Family Friend Other FBCLeander Church Member * Emergency Contact* Phone Number* Please Select Parent Grandparent Aunt/Uncle Family Friend Other FBCLeander Church Member *
Does your child attend Sunday School? if so, where? Church Name* If your child is visiting our church, who is he/she a guest of? Name * May we have permission to photograph your child? Please Select Yes No * May we have permission to use your child's photograph for the purpose of promotion? Please Select Yes No *
Will your child be attending all week? Please Select Yes No What days will Your child be out? Please list the days