First Baptist Church Wednesday Evening Youth Program Registration
This form is required for you to fill out before coming to our Wednesday Evening Youth Programs. You and your household only need to fill this form out once! Please separate each name by a comma. You must be 18 or older to fill out this form.

We are excited to see you again or for the first time!

Event Timing: Every Wednesday from 6-7:30pm, starting September 20, 2023
Event Address: 200 N Mill Street | Colfax, WA 99111

Cubbies - 3-5yrs
Explorers - K-2nd Grades
Grapple - 3rd-6th Grades
Jr. High - 7th-8th Grades (meets at the Annex, next to the Church)

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Email *
Child 1 - Name *
Child 1 - Age *
Child 1 - Birthdate *
Child 2 - Name
Child 2 - Age
Child 2 - Birthdate
Child 3 - Name
Child 3 - Age
Child 3 - Birthdate
Child 4 - Name
Child 4 - Age
Child 4 - Birthdate
Parent(s) Name (First and Last name) *
Mailing Address *
Contact Number (Cell/Work; both if applicable) *
Emergency Contact Name (First and Last name) *
Emergency Contact Number (Cell/Work; both if applicable) *
Please list any allergies or medical conditions. If you are listing for multiple kids, please designate the kid and condition together, separate each combination by a comma (i.e. Susan Anderson Peanuts, Tim Anderson Bees, etc). If you have no allergies or medical conditions, write "None". *
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