Fresno Bible Church - Child and Family Information

Child and Family Information Sheet

FBC Children's Ministry
Please fill out the form below so we can get to know your family a little better!

Child's First Name

Child's Last Name

Nickname

Birthdate

Parent's Names

Home Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Email

Name of other adults and/or older siblings able to pick up your child from their classroom:

For Babies (0-12 months)

Please check all answers that apply to your child

I like to sleep...

on my tummy

on my side

on my back

I am...

breast fed

bottle fed

I___________use a pacifier

do

do not

My parents say I can...

swing in the swing

sit in the infant seat

crawl on the floor

sit in the exersaucer

For Toddlers (13-24 months)

Please check all answers that apply to your child.

I_______________ being potty trained.

am

am not

I______________ have a snack (cookies, crackers, cereal).

may

may not

I_______________ have juice.

may

may not

I______________ drink from a cup.

do

do not

For All Children:

My child has these allergies or medical problems you should know about:

Special Instructions:

Form Completed By:

Child and Family Information Sheet

For Babies (0-12 months)

For Toddlers (13-24 months)

For All Children:

Our Purpose

Service Times

Contact Info

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