* Child's Name: * Birth Date (MM/DD/YYY) : *Current Grade: (2011-2012 School Year)
Parent's *Mother: *Father: *Full Home address:(Street, City, State, zip)
*Cell Phone: *Home or Alt. Phone: *Email address: *Church affiliation: Name and phone of anyone who may also be picking up your child
Name: Phone: Allergies: *Learning Needs : Any custody issues? Select Response No Yes If yes, all documents need to be on file in the Children’s Ministry Office. You give FBC Ocala and/or Children’s Ministry the right to take and use your child’s photo for future FBC publications or Website. Please select one of the following: Select Response PUGGLES (2's-Must be 2 years old by May 1st, 2011.) CUBBIES (3's and 4's-Must be 3 years old by May 1st, 2011.) SPARKS (Kindergarten-2nd Grade) T&T (3rd-6th Grade) 
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