Child's Name *
Child's Name
Child's Birthdate *
Child's Birthdate
Photo/Media Release *
By checking yes below, I give permission for pictures/videos of my children to be used in all FBC Albemarle, including but not limited to website, social media, and promotional materials.
Parent/Guardian Name *
Parent/Guardian Name
Phone # *
Phone #
Parent/Guardian Name
Parent/Guardian Name
Phone #
Phone #
Address
Address