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PBC Kids Enrollment Form

Use the form below to register your child for our PBC Kids ministry.

"*" indicates required fields

Child's Name*

First Last

Gender*

Child's Address*

Street Address Address Line 2 City State ZIP Code

Does your child have any known food allergies? If so please explain.*

Yes

No

Allergy Information*

Mother's Name*

First Last

Mother's Cell Phone*

Text?*

Yes

No

Mother's Email Address*

Is Mother a member of a church?*

Yes

No

If so, where?*

Father's Name*

First Last

Father's Cell Phone*

Text?*

Yes

No

Father's Email Address*

Is Father a member of a church?*

Yes

No

If so, where?*

Who does the child live with?*

Both Mother & Father

Mother

Father

Other

If other, please specify?*

Emergency Contact If parents CANNOT be reached:

Name*

First Last

Relation to Child*

Primary Phone*

Phone Type*

Cell Phone

Home Phone

Work Phone

I give Providence Baptist Church permission to seek emergency medical care for my child in the case I cannot be contacted immediately. In addition, I give Providence Baptist Church permission to photography my child and use those photos in promotional materials.

Medical Care Signature*

Date*

MM slash DD slash YYYY

Release List

Dear Parents,

To increase the safety of our King’s Kids we require each child to have a release list. Parents/Guardians must fill out and sign the form below. No child will be released to anyone that is not on their release list. IDs maybe required so make sure everyone on your release list brings in their ID when signing out your child.

My child will attend the following at Providence Baptist Church:*

Sunday School (9:15 – 10:15 am Sundays East Campus)

Children Church (10:45 am – 12:00 noon Sundays West Campus)

Children’s Choir (5:00 – 6:00 pm Sundays East Campus)

GA’s-Girl’s Mission Group (6:00 – 7:00 pm Sundays East Campus)

RA’s-Boys Mission Group (6:00 – 7:00 pm Sundays East Campus)

King’s Kids (6:00 – 7:30 pm Tuesdays East Campus)

Release List*

Name

Phone Number

To add an additional person, click the "+" at the end of the row.

Parent Signature for Release*

Date*

MM slash DD slash YYYY

2807 Lee Road 166, Opelika, AL 36804
334 745-4608

JOIN US THIS SUNDAY!
West Campus – 8:00 am & 10:45 am services

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June 1

Luke 19:1-10 – “Zacchaeus Needed to See Jesus”

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May 4

John 10:27-30 – “In His Hands”

May 11

Exodus 20:12, Ephesians 6:1-4, 2 Timothy 3:1-2 – “Family”

May 18

John 20:1-23 – “In This Very Room”

May 25

1 Samuel 7:1-13 – “Ebenezer, Never Forget”

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April 6

Matthew 26:30-46 – “Your Will Be Done”

April 13

John 19:16-30 – “Calvary”

April 20

John 20:1-10 – “On the Third Day”

April 27

1 Corinthians 15:12-26 – “What If…”

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March 2

John 1:35-42 – “Come and See”

March 9

John 1:43-51 – “Come and See…”

March 16

John 3:14-17 – “Whoever Believes”

March 23

Luke 3:1-14 – “From the Garden to the Wilderness”

March 30

John 11:1-44 – “The Last Enemy”

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February 2

Matthew 11:28-30 – “Where else could we go..?”

February 9

1 Corinthians 13:12-13 – “Now and Forever”

February 16

Guest Speaker Bro. Russell Dean

February 23

Genesis 22:6-8, John 1:29-34, Matthew 3:17 – “Look to the Lamb”

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January 5

Matthew 2:12-18- “Nobody Said the Journey Would Be Easy”

January 12

John 9:1-12 – “Why him Lord?”

January 19

John 7:53 – 8:12 – “Throwing Rocks in Glass Houses”

January 26

Matthew 14:22-23 – “It’s not an easy walk… To follow Jesus…”

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December 1

Isaiah 7:14; 9:1-7 – “Help Is On the Way”

December 8

Matthew 1:1-17 – “The Journey of Hope”

December 15

Matthew 1:18-25 – “The Story of Integrity and Grace”

December 22

Luke 2:1-20 – “It Just Got Better”

December 29

Matthew 2:1-12 – “The Journey Worth Traveling”

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November 3

2 Chronicles 7:12-16, 1 Peter 2:9-10 – “If… My People”

November 10

Luke 17:11-19 – “Give Him Thanks”

November 17

2 Timothy 4:1-5 – “But You… Stay On Mission”

November 24

Colossians 3:12-17 – “We Give Thanks”

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October 6

Genesis 12:1-3 – “Chosen”

October 13

Daniel 6:1-23 – “Trust and Obey…”

October 20

Psalm 23 – “David Knew”

October 27

John 11:7-44 – “When Jesus Wept”

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September 1

Psalm 116:1-9 – “Grief and Depression”

September 8

Hebrews 13:7-17 – “Remember”

September 15

John 14:1-6, 16, 27 – “Have Faith”

September 22

Matthew 28:16-20 – “The Great Commission”

September 29

Acts 11:1-26 – “Christians First…”

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August 4

Ephesians 6:10-17 – “Finally, Be Strong”

August 11

Luke 5:1-11 – “Lead Us Lord”

August 18

Matthew 5:14-16, Isaiah 49:6 – “Light for Dark Days”

August 25

Matthew 5:13 – “The Salt”

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July 7

Ecclesiastes 3:1-2, Ephesians 2:8-10 – “Seasons of Life”

July 14

John 1:29-34 – “Point Them to Jesus”

July 21

Luke 10:25-37 – “Pass Me Not”

July 28

Luke 22:7-23 – “What the Lord’s Supper Means to Us”

Select an event to view:

8/4/20

Homecoming Concert

11/17/20

James Brown Trio

12/15/21

One Quite Night Christmas Musical