Fuel Registration Form

Fuel Registration Form

    Teen's Information


    Parent or Legal Guardian's Information










    Does your child have any allergies or medical conditions we should be aware of?

    If yes was selected, please fill in the information in the box below

    Please provide 3 emergency contact names & numbers.


    Who can pick you child up from church?


    Does your child need the church van to bring him/her to or from church? (required)

    Would you allow your child to come to our church on Sunday mornings?

    Do you attend a church?

    Can we photograph your child?
    Pictures may be used on the church's website, Facebook, and in other promotional materials associated with Hessmer Baptist Church.