Child Registration Form | Smithfield Baptist Church

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Thank you for taking the time for registering your child(ren). We always want to know the specific needs of your family so we can take better take care of your child(ren).

We look forward in serving you!

Child Registration Form

Today's Date*

Parent's/Guardian's Name 1*

Parent's/Guardian's Name 2

Address*

Emergency Contact Phone Number*( ) -

Name of Emergency Contact if other than Parent

Parent's/Guardian's Email

Name(s) of children & ages*

Special Interest of Child(ren)

Additional Comments

Please leave this field blank.

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