First Baptist Church of Mart KidVenture and VBS Registration

First Baptist Church of Mart Registration

Universal registration for KidVenture and Vacation Bible School (VBS) children’s programs. Use this form to register one or more children and provide parent, medical, emergency, pickup, and permission details.
Program/Session Selection
Program(s) to Register For
Child Information
Child Information
Repeat this section for each child being registered.
Child Name
Child Age
Child Birth Date

MonthDayYear
Date
Child Grade
Parent/Guardian Information
Primary Parent/Guardian Name

First NameMiddle NameLast Name
Relationship to Child(ren)
Primary Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Secondary Parent/Guardian Name

First NameMiddle NameLast Name
Relationship to Child(ren)
Secondary Address (or same as primary)
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Medical/Allergy/Special Needs
Medical conditions
Food allergies
Other allergies
Medications
Special instructions
Emergency Contacts
Emergency Contact 1 Name

First NameMiddle NameLast Name
Relationship to Child
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact 2 Name

First NameMiddle NameLast Name
Relationship to Child
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Authorized Pickup Persons
Name

First NameMiddle NameLast Name
Relationship to child
Phone
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Permissions/Releases
Photo/Video Permission
Applies to all children listed
Parent/Guardian Name
Parent/Guardian Signature
Date

MonthDayYear
Date
Should be Empty:

First Baptist Church of Mart Registration

Program/Session Selection

Child Information

Parent/Guardian Information

Medical/Allergy/Special Needs

Emergency Contacts

Authorized Pickup Persons

Permissions/Releases