Family & Child Updated Info

FAMILY Mailing Address

Apartment, suite, etc.

City

State

Zip/Postal Code

CHILD 1

Birthdate Child 1

Gender Child 1

Grade

School Child 1

Allergies & Medical Conditions Child 1

CHILD 1 - ANYTHING ELSE?

CHILD 2

Birthdate Child 2

Gender Child 2

Grade Child 2

School Child 2

Allergies & Medical Conditions Child 2

CHILD 2 - ANYTHING ELSE?

CHILD 3

Birthdate Child 3

Gender Child 3

Grade Child 3

School Child 3

Allergies & Medical Conditions Child 3

CHILD 3 - ANYTHING ELSE?

If you have more than 3 children, continue filling out the first form, submit it, then refresh the page and continue filling out info.

PARENT/GUARDIAN 1 - person allowed to pick up

PARENT 1 - Phone Number

PARENT 1 - Email

PARENT/GUARDIAN 2 - person allowed to pick up

PARENT 2 - Phone Number

PARENT 2 - Email

EMERGENCY CONTACT - Name & Phone Number

PERMISSION TO PICK UP

I allow Fairview: The Grace Place to photograph and/or video my child for promotional and advertisement materials. These photographs and/or videos may be used in printing, church verified social medias, church website, church app, and any and all forms of content where Fairview: The Grace Place may be featured. Please check yes or no.

Please select yes or no:

Yes

No

Signature

Further questions, please contact Pastor Meredith - meredith@fairviewthegraceplace.com