First Baptist Church Harrison

First Name

Last Name

Phone Number

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Name(s) of Approved Pick Up Person(s):

Alternate # to contact in case of emergency (include area code)

Do you have a church home?

Yes

If so, where?

Child

First Name

Last Name

Age or Grade entering as of June 1

Allergies / Other Health Concerns (think snacks, stings, diabetes, etc.)

"May I give you a gift?"

"In the front of this book is help for life's difficult situations."

"In the back is a test that will tell you if you were going to heaven."

"I want to invite you to come to my church.
There's a card in the book that gives you all the information."