Living Water Bible Fellowship Children's Ministry
Child Registration and Release Form
General Information
Child's Last Name: *
Your answer
Child's First Name: *
Your answer
Child's Birthdate: *
MM
/
DD
/
YYYY
Age *
Your answer
Sex of the Child: *
Age Group *
Address: *
Your answer
City: *
Your answer
State: *
Your answer
Zip: *
Your answer
Name of Parent(s)/Guardian(s) *
Your answer
Relationship to child
Your answer
Email *
Your answer
Home phone *
Your answer
Cell Phone
Your answer
Name of adult(s) bringing child(ren) to LWBF (if different from above)
Your answer
Address
Your answer
Phone
Your answer
Emergency Contact (other than parent)
Your answer
Address
Your answer
Phone
Your answer
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