Ignite 2025-2026 Online Registration

Your name *

Last name

Email address *

Primary Phone Number *

Secondary Phone Number

Child's Name *

Gender *

Birthdate *

Grade *

I have another child to register

Medical or other information we need to know BY NAME(s). (Please include food allergies.)

Address *

HomeWorkOther

Country

Country

Street address

Apt/unit/box (optional)

City

State

Postal code

Emergency Contact *

Name

Emergency Contact *

Phone Number

Name of home church, if any:

I hereby authorize that my child(ren) may participate in all Ignite events. This authorization is extended for all Ignite-sponsored activities, including any special events, both on the church grounds and off the premise. *

I hereby GRANT or DO NOT GRANT (circle one) permission for Vilonia First Baptist to use pictures of my child(ren) on their website and/or social media platforms for informational or promotional purposes. *

GRANT

DO NOT GRANT

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