Home > Services > Registration for Families with ChildrenRegistration for Families with Children Step 1 of 7 14% URLThis field is for validation purposes and should be left unchanged.Parent/Guardian (Primary)(Required) First Last Cell Phone (Primary)(Required)Email (Primary)(Required) Enter Email Confirm Email Parent/Guardian (Secondary) First Last RelationshipCell Phone (Secondary)Email (Secondary) Enter Email Confirm Email Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Children's RegistrationChild 1's Name(Required) First Name Last Name Child 1's Date of Birth(Required) Month Day Year Child 1's Grade(Required)Do you have more children to register?(Required) Yes No Registering 2nd Child#2 Child's Name First Name Last Name #2 Child's Date of Birth Month Day Year #2 Child's GradeYou've Registered 2 Children. Do you have more children to register? Yes No Registering 3rd Child#3 Child's Name First Name Last Name #3 Child's Date of Birth Month Day Year #4 Child's GradeYou've registered 3 children. Do you have more children to register? Yes No Registering 4th Child#4 Child's Name First Name Last Name #4 Child's Date of Birth Month Day Year #4 Child's GradeYou've registered 4 children. Do you have more children to register? Yes No Registering 5th Child#5 Child's Name First Name Last Name #5 Child's Date of Birth Month Day Year #5 Child's GradePlease note: you have registered 5 children.If you need to register more, first please complete and submit your form entry. Then there are 3 options: You can contact us directly to register more children by either directly emailing us at office@murdockbaptistchurch.com; call 941-627-6352; or you can even re-submit a new form with those additional children at: Children's Registration Form. Special NeedsAre there any allergies or special needs?(Required) Yes No Unsure Please list:Please note the child's name and what their needs are individually if you are registering multiple children.Person(s) AUTHORIZED to pick up your child (children):Please list names and please let those authorized persons know we will require ID.Any additional notes or comments you would like us to know. Δ Share this: Share on Facebook (Opens in new window) Facebook Share on X (Opens in new window) X
