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King's Kids Registration






Please fill out the form completely

      Boy        Girl
Name 
Address
 
 Phone
                      Parent Cell Phone  
Parent or Guardian

Allergies/ Med Info

Emergency Contact
            Phone  
Birth Date (m/d/y)
          Age          
T-Shirt Size
    YXS    YS    YM    YL    YXL    AS    AM      AL    AXL
Grade
          
 



 

        

Liberty Baptist Church  | 536 S. Victory Drive  |  Lyons, GA  30436  |  Pastor Michael Plowman

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