Tolar Baptist Church - Youth (K-12th) Registration

Parent/Guardian

First Name

Last Name

Phone Number

Email

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Child

First Name (Child)

Last Name

Birthdate

Gender

Phone Number (Child #)

Grade

Allergies

Child main transportation?

Please list any medical needs we need to be aware of?

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Emergency Contact

First Name

Last Name

Phone Number