There are forms for 3 children, if you only have one or two, just leave the others blank. If you have more than 3 children, you can add them in the “more information” box at the bottom or submit this one and fill it out again.
Parent's full name (called by):
[first, middle, (maiden), last] (write name called by in parentheses)
Field is required!
Field is required!
Parent's full name (called by):
[first, middle, (maiden), last - write none if applicable]
Field is required!
Field is required!

Address:

Street address:
Field is required!
Field is required!
City
Field is required!
Field is required!
State
Field is required!
Field is required!
Zipcode
Field is required!
Field is required!
Email Address:
Field is required!
Field is required!
Additional Email Address:
Field is required!
Field is required!
Phone Number:
Field is required!
Field is required!
Additional Phone Number:
Field is required!
Field is required!
Number of children being registered:
  • - select a option -
  • One
  • Two
  • Three
  • More
- select a option -
Field is required!
Field is required!

First child information:

Child's first, middle & last name (called by):
Field is required!
Field is required!
Gender:
Field is required!
Field is required!
Date of birth:
Select a date
Field is required!
Field is required!
Child Allergies or Medical Concerns:
(write none if applicable)
Field is required!
Field is required!

Second child information:

Child's first, middle & last name (called by):
Field is required!
Field is required!
Gender:
Field is required!
Field is required!
Date of birth:
Select a date
Field is required!
Field is required!
Child Allergies or Medical Concerns:
(write none if applicable)
Field is required!
Field is required!

Third child information:

Child's first, middle & last name (called by):
Field is required!
Field is required!
Gender:
Field is required!
Field is required!
Date of birth:
Select a date
Field is required!
Field is required!
Child Allergies or Medical Concerns
(write none if applicable)
Field is required!
Field is required!
I give Christ Episcopal Church permission to take pictures of my child at church events and to use those pictures for church publications :
Field is required!
Field is required!
More information (additional contact information or other children may be added here if needed):
Field is required!
Field is required!