Wednesday Night Ministry Registration Form
Children's Creative Arts - 6:00pm - 6:50pm
3s    4s    Kindergarten
1st   2nd  3rd  4th  5th  6th
RA's, GA's & Mission Friends - 6:50pm - 8:00pm
Mission Friends
3s    4s    Kindergarten
Royal Ambassadors
1st   2nd  3rd  4th  5th  6th
Girls in Action
1st   2nd  3rd  4th  5th  6th
Preschool (Childcare) - 6:00pm - 8:00pm
Babies / Toddlers
Walkers thru 2s
Preschool services for birth to 2 years are only available in an on-campus ministry Wednesday nights.
Child's Name:
Address:      
City:             St.
Boy  Girl   Age: (As of Sept 1, 2009)  D.O.B
School:         Grade:
Parents Name:
Cell Phone:     
Child's Cell:     
Home Phone:  
Parent's email:

 I attend church: (please check one)
Sometimes  Never  Every Sunday  Often 
 Where?:

In case of emergencies please contact: 
Emergency Contact Number:
Allergies or additional information: 
Where is the parent during music and missions? (6:00pm - 8:00pm)
Policies on the release of children

Parents will be required to sign- in and pick up children birth through 5th grade from their rooms. 6th grade will not require a parent to pick them up or sign them in, from their classroom.. Parents will be asked to leave an emergency phone number where they can be reached.

*Required Fields

 

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Mimosa Lane Baptist Church - 972-288-7426 - info@mimosalane.org