Sunday School Registration

Child's Name *

First

Middle

Last
Age *
Grade *
1. Parent/Guardian *

First

Last
Relationship to Child *
Cell & Home phone numbers. *
Email Address *
Mailing Address
2. Parent/Guardian *

First

Last
Relationship to Child *
Cell & Home phone numbers. *
Email Address
Mailing Address *
Emergency Contact Information

Please provide an emergency contact other than the two parents/guardians listed above
Name *

First

Middle

Last
Relationship to child *
Cell / Home / Work *
Child's Heath info

Please complete the below health information. You can list any additional details in the space below.
Please list all allergies/sensitivies your child has *
Does your child carry an Epi-Pen for allergies? If YES, you are required to provide your child's FBC leader with one. *

Yes No
List any conditions/behavioural / or special circumstances your child has
I agree for FBC to use my child's images for internal church publications? (Such as newsletter, bulletins) or for public domain (such as FBC website)? *

Yes No
Date *

Emergency Contact Information