SEEDS

Registration

 

Child Info

* Child's Name:

* Parent/Guardian Name:

* Address:

Phone Numbers:

Home

Work

Cell

* E-mail:

Date of Birth:

Age:

 

How Can We Best Care for Your Child

Medical Information:
Medical or other information we need to know.  (Please include any food allergies.)

Emergency Contact:
 * Name

* Phone Number

Name

Phone Number

* Dismissal Information:
Who may pick up your child at the end of each Seeds night?

Other Information:
Do you attend Sunday School or Worship Service? If so where?

If you are visiting our church, who are you a guest of?

Is there any other concerns or questions you have that we need to address?


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