Kid City Registration

Child(ren) Information *		Order
	First Name * Last Name * Gender * Age/Grade * Birthday * Month Day Year Allergies/Special Needs	Weight for row 1

Parent/Guardian Information *		Order
	First Name * Last Name * Phone * I agree to receive SMS messages from Lancaster Baptist Church * No Yes By submitting contact information through this form, I agree that Lancaster Baptist Church and its affiliates may call and/or text me about its offerings by any phone number I have provided and may provide in the future, including any wireless number, using automated technology. Message and data rates may apply. For additional information, text HELP to any number from which you receive messages from us. You may opt out at any time by replying STOP to any message from us. Privacy Policy Relationship to Child * Marital Status * Life Stage *	Weight for row 1

General Information

Address 1 *

Address 2

City *

State *

ZIP code *