Children’s Ministry Online Registration

Please fill out one form for each of your children. This information will be shared with your child’s teacher(s). Thank you for your help in keeping our children safe while they are at Hominy Baptist Church.

Child's Name *
Child's Name
Date of Birth: *
Date of Birth:
Parents' Names *
Parents' Names
Emergency Phone Number: *
Emergency Phone Number:
Additional Phone Number:
Additional Phone Number: