REGISTRATION FORM - PRIMARIES - West Jacksonville Baptist

2024-2025 Master Club Registration

* Indicates required field

Child's Name *

First

Last

Parent or Legal Guardian's Name *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number (For emergency contact) *

Child's grade they enroll in this year *

Child's Birthday (Month) *

Child's Birthday (Day) *

Child's Birthday (Year) *

Primaries

Club Shirt Size *

Purchase Club Materials? *

Respect for leaders, respect for each other.

Master Club leadership have permission to photograph/film the minor designated above for any lawful purpose associated with this ministry program. *

Yes No

Parent/Guardian Signature (Please type your name below. This form will be available for signature when dropping off your child) *

Submit