Children’s Formation Registration This form will be automatically emailed to St. John's Episcopal Church. Child's Name * First Name Last Name Date of Birth MM DD YYYY Grade Second Child's Name First Name Last Name Date of Birth MM DD YYYY Grade Third Child's Name First Name Last Name Date of Birth MM DD YYYY Grade Parent/Guardian Name First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Parent/Guardian Email Address * Parent/Guardian Name First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Parent/Guardian Email Address Emergency Contact * First Name Last Name Emergency Contact Phone * (###) ### #### Special Notes (allergies, special needs, etc.) 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. I DO give permission I DO NOT give permission Thank you for connecting with us. May God’s blessing be with you and with those you love.
