2016-2017 Godly Play Registration

This form will be automatically emailed to St. John's Episcopal Church.

Child's Name *
Child's Name
Date of Birth
Date of Birth
Child's Name
Child's Name
Date of Birth
Date of Birth
Child's Name
Child's Name
Date of Birth
Date of Birth
Address
Address
Phone *
Phone
Parent/Guardian Name
Parent/Guardian Name
Address 1
Address 1
Phone
Phone
Emergency Contact
Emergency Contact
Emergency Contact Phone
Emergency Contact Phone
Permission *
St. John's Episcopal Church | Lafayette may take photographs during this event. We use these photos to record our history and illustrate church life in our newsletter, on our website, and/or on social media. Please indicate whether or not you give permission for photos of your child/ren to be used in this way.