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FBC Kids 2021

Child's Name *

First Name

Last Name

Parent/Guardian Name *

First Name

Last Name

Email Address *

Best Phone Number *

(###)

###

####

Best Form of Contact *

Call

Text

Email

Facebook

Emergency Contact (Name and phone of someone not living in the home) *

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you attend church regularly? If so, where?

Please list the names of those who are allowed to pick up this child *

Is this child a boy or a girl? *

Boy

Girl

What grade is this child in? *

Nursery (children of leaders)

Pre-K (children of leaders)

K

1

2

3

4

5

6

Please list any food allergies or other needs you want us to be aware of

Thank you!

Facilities Request Give

First Baptist Church

701 West 3rd Street,

Corning, AR, 72422,

United States

8708579730 admin@corningfbc.com

Hours

Sermons

Corning First Baptist Church

701 W 3rd St

Corning, Ar 72422

870-857-3790

Office Hours: T-Th 9-3