Dad's Name *

Email *

Daytime Phone *

Preferred method of contact *

Phone

Email

Home Address *

City *

State/Province *

Zip/Postal Code *

Daughter's Name *

Daughter's Date of Birth * +

Addt'l Daughter's Name

Addt'l Daughter's Date of Birth +

Addt'l Daughter's Name

Addt'l Daughter's Date of Birth +

Are you a member of Second Baptist Church? *

If not, where do you attend church? *

PAYMENT INFORMATION

PAYMENTS WILL BE ACCEPTED AT SECOND BAPTIST CHURCH-SOUTH CAMPUS THROUGH WEDNESDAY, SEPTEMBER 21ST.

Fee Amounts *

1 Daughter- $25

2 Daughters- $35

3 Daughters- $45

Photography Release: I/ We agree that Second Baptist Church may use photographs and/or video footage of my child(ren) for communication, publicity, advertisement, or other publications by Second Baptist Church. *

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