The first time you use this site you will be required to enter your email address and create a unique secure password. Please remember your password for return visits. RM_StatsEmail *Username *Password *Password must be at least 7 characters long.Enter password again *Password must be at least 7 characters long.Please complete all fields to the best of your ability. The form cannot be submitted with any fields denoted with an * left blank.Guardian's informationGuardian's First Name *Guardian's Last Name *Guardian's Relationship to the Child *Guardian's Cell Phone Number *Guardian's Address Address Line 1 Address Line 2 City State or Region Alabama Alaska Arizona Arkansas Armed Forces America Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State or Region Country Zip Emergency Contact Name *Emergency Contact Phone Number * Child's InformationChild's First Name *Child's Last Name *Child's Address Address Line 1 Address Line 2 City State or Region Alabama Alaska Arizona Arkansas Armed Forces America Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State or Region Country Zip Child's Birthdate *Child's Age *Allergies/Medical Conditions *Please list any allergies or medical conditions that we should know about to keep this child safe. Enter NONE if there are no conditions present.Photos/Videos * Allow photos/videos Do Not Allow photos/videos First Baptist only uses photos and videos for historical documentation and promotion of future events and will not sell or redistribute these to outside groups. First Baptist does not allow any identifying information (names, ages, addresses, or phone numbers) to appear with photos/videos containing minors. I hereby certify that I am the legal guardian to the minor(s) above and to the best of my knowledge and belief, the above statements are true and that the minor(s) named above has my approval to remain at First Baptist Church of Greater Cleveland without my presence.Guardian's Signature *By signing this document you are agreeing to allow this minor to be at First Baptist Church without your presence. You will receive confirmation of this agreement.Date Signed *Name of Person(s) Allowed to Pickup Child * Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
