Get Real 2007 Registration Form

October 13th, 2007 from 1:00pm - 4:00pm

First Southern Baptist Church - Floyds Knobs, IN

Please fill out the form below with the girl's information to register for Get Real 2007

                       *please register each girl individually*

Name:                               

Address:                            

Phone Number:                  

Email Address:                   

Birth Date:                         

Age                                   

Does the family have a home church?    Yes         No    

If so, where?                      

Child's medical, allergy, or other information we may need to know:

               Important Info

Emergency Contact One:    

Emergency Contact Two: