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Registracion del Participante

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First Church of God

Location

2627 Niles Ave

Saint Joseph, MI 49085

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Contact Micah Lange:

269-369-3171

micah.l@myfirstchurch.com

Primero, cuéntenos sobre usted:

Información de los Padres

Nombre

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Apellido

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Correo Electrónico

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Dirección 1

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Dirección 2

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Ciudad

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Estado/Provincia

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ZIP/Código Postal

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País

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Teléfono de Contacto 1

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Nombre del Contacto de Emergencia

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Relación del Contacto de Emergencia

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Teléfono del Contacto de Emergencia

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Nombre de recogida alternativo

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Teléfono de recogida alternativa

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Afiliación de la iglesia local

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New This Year PRESCHOOL ONLY!!

Pick up Password.

Below there is space for you to provide a pick up password that ANYONE who picks up your child will need to provide. The password can be a numerical sequence (1,2,3,4) or a word ( Poppyseed ). This will be used upon picking up PRESCHOOLERS EACH evening.

Pick up Password.

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Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Cuéntanos sobre tu participante

Nombre

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Apellido

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Grado Saliendo

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Género

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Fecha de nacimiento

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Allergies/ Medical Concerns

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¿Tienes amigos con los que te gustaría estar juntos? Haremos todo lo posible para juntar a los amigos seleccionados en el mismo grupo, pero no podemos prometer que todas las solicitudes serán posibles.

Amigo 1 Nombre

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Amigo 1 Apellido

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Amigo 2 Nombre

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Amigo 2 Apellido

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Comentarios

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I DO NOT want my child photographed

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