FBC Sunday School
Registration Form
Registration
Information received is confidential and is being gathered for the purposes of serving your Child while in the care of Fellowship Baptist Church Collingwood. Any medical information collected here serves to authorize Fellowship Baptist Church Collingwood, and its staff and volunteers, to obtain medical assistance in emergencies.
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PARENT / GUARDIAN INFO
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
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CHILD'S CONTACT INFO
How many children will be attending Sunday School?
*
Please Select
1
2
3
1st Child's Info
Name
*
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Grade
2nd Child's Info
Name
*
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Grade
3rd Child's Info
Name
*
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Grade
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CHILD'S MEDICAL NEEDS
Do any of your children have any severe allergies? (bee stings, food, etc.)
*
Yes
No
Please identify which child, explain and indicate if an EpiPen is required
Will any of your children be bringing any medication with them? (inhaler, etc.)
*
Yes
No
Please indicate which child, explain and indicate if they self administer or if they require assistance
Do any of your children have any physical, emotional, mental, or behavioral concerns or limitations that our staff should be aware of?
*
Yes
No
Please identify which child and explain
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CONSENT & ACKNOWLEDGMENT
FBC Privacy Policy
Signature
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