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Participant Registration

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Fairview Church

Location

2508 Old Niles Ferry Rd

Maryville, TN 37803

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Contact Donna Henry:

865-983-2080

dhenry@fairview-church.org

First, Tell Us About Yourself:

Parent Information

***Please note that registration for PreK through rising Kindergarten is now closed, as we have reached the maximum capacity we can safely accommodate. Registration remains open for rising 1st–6th grades. Thank you so much for your understanding and for partnering with us—we are grateful for your families!***

If you would like to be added to a waiting list for this group, please email sgoss@fairview-church.org.

First Name

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Last Name

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Address 1

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City

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State/Province

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ZIP/Postal Code

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Contact Phone 1

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Contact Phone 2

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Text Message Phone

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Alternate Pickup Name

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Alternate Pickup Phone

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Alternate Pickup 2 Name

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Alternate Pickup 2 Phone

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Home Church Affiliation

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Comments

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Other Emergency Contacts (name, relationship to child, and phone #)

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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.

Tell Us About Your Participant

First Name

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Last Name

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Grade Entering

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Gender

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Date Of Birth

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Allergies

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Medical Concerns

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Do you have friends you would like to be placed with? We will do our best to group selected friends together in the same crew, but we cannot promise all requests will be possible.

Friend 1 First Name

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Friend 1 Last Name

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Friend 2 First Name

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Friend 2 Last Name

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Friend 3 First Name

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Friend 3 Last Name

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Comments

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Yes/No: I grant permission to Fairview Church to use my child's image in print, video and digital media. I agree that these images may be used by Fairview Church for a variety of legally permissible purposes; and that these images may be used without further notifying me.

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In the event of a medical emergency: Fairview Church is authorized to obtain medical treatment and procedures for the child as may be appropriate in emergency circumstances, including treatment by physicians, hospital and clinic personnel, and other appropriate health care providers.

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