RBC Kingdom Kids Ministry Information Form

Child’s Name:

Birthday:

Parent’s Name:

Parent’s Name:

Address:

Phone Number:

Email:

Can we contact you through a text message?

Allergies:

Emergency Contact:

Name:

Phone Number:

Is there anyone that cannot pick up your child?

Do you give Russellville Baptist permission to photograph your child? (Photos may be used on the website.)

Click Email

Send to: rbckingdomkids@gmail.com