First Presbyterian Kids' Ministry
We are so excited for your child to be a part of Kids' Ministry at FPC! Please take a moment to share some information about your child! We use the below information to keep track of children within our Check In system for Sunday Mornings (Sunday School at 9:30 and Worship Childcare at 10:50) or Wednesday afternoons (Crossings 4:30-6:00).

Feel free to contact us at anytime!
Beth Barnard - Children's Director
beth@myfirstpres.org
940-781-8141

Email address *
Child's Name *
Your answer
Child's Birthday *
Your answer
Grade *
Your answer
School Attending *
Your answer
Mother's Name *
Your answer
Father's Name *
Your answer
Address *
Your answer
Phone Number *
Your answer
Does your child have any food, medication or environmental allergies? *
Required
How should we respond if he/she has an allergic reaction? *
Your answer
Does your child have a special health or medical condition? *
Required
Is your child taking any medication? Parent is responsible for administering medication to child. The only medication given at FPC is epi-pen for severe allergic reactions. *
Required
Does your child have emotional, behavioral or physical needs? (Speech, hearing loss, learning disability, or other special diagnosis) *
Your answer
Does your child have any dietary restrictions, including medical or cultural? *
Your answer
Does this dietary restriction require a modified diet that eliminates all types of milk or an entire food group? *
Your answer
I verify the above information listed on this form is true, correct and complete. *
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