First United Methodist Church
Saturday, October 21, 2017
Growing and Sharing our Faith in God

First Friends Registration

 

Registration Form

Child's Information

Child's Name
Child's Gender
Child's Age
Child's Date Of Birth
Home Address
City
State
Zip Code
Home Phone #
 

Father's Information

Father's Name
Father's Cell Phone
Father's Employer
Father's Employer Phone
 

Mother's Information

Mother's Name
Mother's Cell
Mother's Employer
Mother's Employer Phone
 

Other Children in the Family

Child 2 Name  Age  Gender   
Child 3 Name  Age  Gender
Child 4 Name  Age  Gender
 

Releases

Please list people other than parents to whom your child may be released.
Release 1 Name  Phone #  Relationship
Release 2 Name  Phone #  Relationship
Release 3 Name  Phone #  Relationship
Note:If the child is to be released to someone other than parents or the listed then a note is required with your signature on that day.
 

Other 

Does the child:
Have Allergies (if so please list)
 
Take Medications (if so please list)
 
Have Any Other Conditions We Should Know About      
 
How did you learn about our preschool? (place an x in the box if yes) 
Times Bulletin          Other Parents     Channel 4     
Other(please explain)
 
E-mail Address (without this we will not be able to complete your registration)  
Registration is not complete until we have received you non-refundable registration fee of $40.