Bethesda Friends Meeting (BFM)
First Day School (FDS) Registration and Emergency Form
Please fill out a separate registration form for each of your children
Youth Safety Policy: Have you read the 2021 Policy found on BFM website? https://www.bethesdafriends.org/Children#safety
*
I have read the policy
I will read the policy
Other
Parent/Guardian NAMES
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary mobile phone
*
-
Area Code
Phone Number (also type owner's name)
Secondary mobile phone
-
Area Code
Phone Number (also type owner's name)
Primary email
*
example@example.com
Secondary email
example@example.com
Child's name and preferred pronoun
*
Please complete a separate registration form for each child
Birthdate
*
-
Month
-
Day
Year
Birthdate
Current age & grade
*
Current school name
*
Allergies, and if medicines are required.
*
If no answer, please type NONE.
I would like an FDS teacher to call me about special needs, questions, or concerns for this child.
Yes
No
Other
Photo Release: I give BFM permission to take this child's photo.
*
Yes
No
Other
Photo publication: I give BFM permission to print the photo on BFM materials or post it on BFM website.
Yes, with first but not last name
Yes, but without a first or last name
Please contact me before using my child's photo
Please do not print, share, or post my child's photo
Other
Other information you would like the FDS teachers to know.
*
If no answer, please type NONE.
Today's date
*
-
Month
-
Day
Year
Date
Please verify that you are human
*
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