November 5, 2021 6:00pm - 10:00pm at the ROC Dinner, Christmas games, cookie decorating, and hot cocoa! Registration is FREE with a donation for Operation Christmas Child Jingle Jam Lock-InHow many children will you be registering today?One ChildTwo ChildrenThree ChildrenFour ChildrenFive ChildrenChild #1Child's Name* First Last Child's Age*Child's Birthdate* MM slash DD slash YYYY Grade Completed*Registration for kids that have completed kinder - 6th grade.Kinder1st2nd3rd4th5th6thGender*FemaleMaleAllergiesPlease list any allergies or special medical conditions that FBCL staff should be aware of for this event.Photo Permission*My child's picture may be taken and used by First Baptist Church of Longview for use on the FBCL website and social media channels. Yes No Child #2Child's Name* First Last Child's Age*Please enter a number from 1 to 100.Child's Birthdate* MM slash DD slash YYYY Grade Completed*Registration for kids that have completed kinder - 6th grade.Kinder1st2nd3rd4th5th6thGender*FemaleMaleAllergiesPlease list any allergies or special medical conditions that FBCL staff should be aware of for this event.Photo Permission*My child's picture may be taken and used by First Baptist Church of Longview for use on the FBCL website and social media channels. Yes No Child #3Child's Name* First Last Child's Age*Please enter a number from 1 to 100.Child's Birthdate* MM slash DD slash YYYY Grade Completed*Registration for kids that have completed kinder - 6th grade.Kinder1st2nd3rd4th5th6thGender*FemaleMaleAllergiesPlease list any allergies or special medical conditions that FBCL staff should be aware of for this event.Photo Permission*My child's picture may be taken and used by First Baptist Church of Longview for use on the FBCL website and social media channels. Yes No Child #4Child's Name* First Last Child's Age*Please enter a number from 1 to 100.Child's Birthdate* MM slash DD slash YYYY Grade Completed*Registration for kids that have completed kinder - 6th grade.Kinder1st2nd3rd4th5th6thGender*FemaleMaleAllergiesPlease list any allergies or special medical conditions that FBCL staff should be aware of for this event.Photo Permission*My child's picture may be taken and used by First Baptist Church of Longview for use on the FBCL website and social media channels. Yes No Child #5Child's Name* First Last Child's Age*Please enter a number from 1 to 100.Child's Birthdate* MM slash DD slash YYYY Grade Completed*Registration for kids that have completed kinder - 6th grade.Kinder1st2nd3rd4th5th6thGender*FemaleMaleAllergiesPlease list any allergies or special medical conditions that FBCL staff should be aware of for this event.Photo Permission*My child's picture may be taken and used by First Baptist Church of Longview for use on the FBCL website and social media channels. Yes No Parent or GuardianParent or Guardian Name* First Last Parent or Guardian Email* Parent or Guardian Phone*CAPTCHANameThis field is for validation purposes and should be left unchanged.
