Page 35 | Eastvue Baptist Church

Child's Name: (Required)

Birthday (Required)

Your Phone Number (Required)

Emergency Contact (Required)

In the event of an emergency, who do we contact? Phone number?

Allergies or Medical Info (Required)

Who will be picking your child up? (Required)

Solve 4 + 5 = ?

Our Mission

We seek to Love God, Love People, and Make Disciples in our community and in the world.

Eastvue Baptist Church

1220 Pepper St; P.O. Box 383

Jena, LA 71342

318-992-4460

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