Registration for Families with Children

Step 1 of 2

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

Parent/Guardian (Primary)(Required)

Cell Phone (Primary)(Required)

Email (Primary)(Required)

Parent/Guardian (Secondary)

Relationship

Cell Phone (Secondary)

Email (Secondary)

Address

Children's Registration

Child 1's Name(Required)

Child 1's Date of Birth(Required)

Child 1's Grade(Required)

Registering 2nd Child

#2 Child's Name

#2 Child's Date of Birth

#2 Child's Grade

Registering 3rd Child

#3 Child's Name

#3 Child's Date of Birth

#4 Child's Grade

Registering 4th Child

#4 Child's Name

#4 Child's Date of Birth

#4 Child's Grade

Registering 5th Child

#5 Child's Name

#5 Child's Date of Birth

#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.

Children's Registration

Registering 2nd Child

Registering 3rd Child

Registering 4th Child

Registering 5th Child

Special Needs

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