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Update Your Contact Information

In our attempt to improve and speed up the dissemination of info on upcoming events, I would like to update my database with your contact information in order to email and/or text message updates and information regarding the FBBC Children’s Ministry.

* Required Field

Child(ren's) Names: * Last: First:
    Last: First:
    Last: First:
    Last: First:
    Last: First:
    Last: First:
     
Primary Address: *
City, State, Zip: *
Phone: *
     
Secondary Address:  
City, State, Zip:  
Phone:  
     
Primary Email: *
Secondary Email:  
Would you like receive Children’s Ministry Update Emails?  Yes    No
     
Mom's Name: *
Mom's Cell Phone:  

Would you like to receive text messages on this phone:  Yes    No

     
Dad's Name: *
Dad's Cell Phone:  

Would you like to receive text messages on this phone:  Yes    No

     
Guardian's Name:  
Guardian's Cell:  

Would you like to receive text messages on this phone:  Yes    No

     

Name of person completing this form: *

     

 

 

     
 

--Florida Boulevard Baptist Church ~ 10915 Florida Boulevard ~ Baton Rouge, LA 70815 ~ (225) 272-3740

 

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