Child Registration Form - Incarnation Anglican Church

Child Info

Name of child

Gender

Birthday

Grade

Medical Note

Allergies?

Has your child been baptized? *

Anything else we should know?

I give permission for pictures/videos, in which my child appears as a program participant, to be used in Incarnation brochures, flyers, social media, and/or other promotional materials published and distributed by Incarnation Anglican *

Guardian info

Emergency Contact (can be a parent) *

Name (First Last), phone number

List parents, grandparents, or caregivers with permission to pick up this child:

First Last