Emmanuel Episcopal Church, Athens, Georgia

Children/Youth Formation Registration

Formation Registration

Child's First Name

Child's Last Name

Date of Birth

Child's Age or Grade in School

Name of School

Parent/Caregiver's Name

Primary Email Address

Secondary Email Address

Mailing Address Including City and Zip Code

Parent Contact Cell Phone Number

Emergency Contact Name and Cell Phone

List Medical/Behavioral Issues

I give permission for my child's photo to be used on Emmanuel's website, social media pages, bulletin boards, e-letter or other publications.

Yes

If you answered no, please list photo limitations, if applicable

I understand reasonable safety precautions are taken by Emmanuel Episcopal Church and its agents during formation activities. I agree not to hold Emmanuel Episcopal Church of Athens, its leaders, vestry, employees and volunteers liable.

I agree

Parent/Guardian Signature

Complete all information and click submit

Contact Details

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Children/Youth Formation Registration

Formation Registration

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