First Baptist Church Remote Learning Center
**Please complete 1 form per child.  Once you complete the form, someone from the church office will contact you.  
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Parent/Guardian Name(s) *
Child Name *
Home Address *
Phone Number *
Email Address *
Name of Child *
School the child attends *
Grade *
Does your child have any specific learning needs? *
What days of the week would you be sending your child?
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