Child Registration
General Info
First Name
*
Date of Birth
*
Last Name
*
School Grade
*
-- None --
Nursery 0-1
Nursery 1-2
Nursery 2-3
Pre-school 3-4
Pre-School 4-5
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Allergy & Medical Information
Others allowed to pick up my child:
Photo Release
I hereby __________ First Alliance Church to use pictures of my on it's website for informational or promotional purposes.
*
Grant
Do Not Grant
Emergency Contact
Name
*
Phone Number
*
Parent Information
First Name
*
First Name
Last Name
*
Last Name
Home Address
*
Home City
*
Home State
*
Home Zip Code
*
Email Address
*
Phone Number
*
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