Parent's full name (called by):
[first, middle, (maiden), last] (write name called by in parentheses)
Parent's full name (called by):
[first, middle, (maiden), last - write none if applicable]

Address:

Email Address:
Additional Email Address:
Phone Number:
Additional Phone Number:
What formation opportunity?:
Number of children being registered:
  • - select a option -
  • One
  • Two
  • Three
  • More

First child information:

Child's first, middle & last name (called by):
Gender:
Date of birth:
Child Allergies:
(write none if applicable)

Second child information:

Child's first, middle & last name (called by):
Gender:
Date of birth:
Child Allergies:
(write none if applicable)

Third child information:

Child's first, middle & last name (called by):
Gender:
Date of birth:
Child Allergies:
(write none if applicable)
I give Christ Episcopal Church permission to take pictures of my child at church events and to use those pictures for church publications :