Online Family Registration Card
Children's Ministry at Bent Creek Baptist Church
Parent/Guardian Name 1
Your answer
Email
Your answer
Cell Number
Your answer
Relationship to Child
Does this adult live at the address below?
Parent/Guardian Name 2
Your answer
Email
Your answer
Cell Number
Your answer
Relationship to Child
Does this adult live at the address below?
Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Please list the names of individuals, other than the parents/guardians listed above, who are authorized to pick up your child.
Your answer
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