Registration for Families with Children

Step 1 of 7

14%

Parent/Guardian (Primary)(Required)

First Last

Cell Phone (Primary)(Required)

Email (Primary)(Required)

Enter Email Confirm Email

Parent/Guardian (Secondary)

First Last

Relationship

Cell Phone (Secondary)

Email (Secondary)

Enter Email Confirm Email

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Children's Registration

Child 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

Registering 2nd Child

#2 Child's Name

First Name Last Name

#2 Child's Date of Birth

Month

Day

Year

#2 Child's Grade

You've Registered 2 Children. Do you have more children to register?

Yes

Registering 3rd Child

#3 Child's Name

First Name Last Name

#3 Child's Date of Birth

Month

Day

Year

#4 Child's Grade

You've registered 3 children. Do you have more children to register?

Yes

Registering 4th Child

#4 Child's Name

First Name Last Name

#4 Child's Date of Birth

Month

Day

Year

#4 Child's Grade

You've registered 4 children. Do you have more children to register?

Yes

Registering 5th Child

#5 Child's Name

First Name Last Name

#5 Child's Date of Birth

Month

Day

Year

#5 Child's Grade

Please 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 Needs

Are there any allergies or special needs?(Required)

Yes

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.

This field is for validation purposes and should be left unchanged.

Children's Registration

Registering 2nd Child

Registering 3rd Child

Registering 4th Child

Registering 5th Child

Special Needs

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