Child Information Form - All Saints Anglican Church

Phone number *

Address

Birthdate *

Gender *

Grade

Parents & Guardians *

List the name(s) of all persons who are authorized to pick up your child on your behalf. Please also list their contact information as these will be the individuals that we reach out to in the case of an emergency.

Are there any specific individuals who cannot pick up your child? *

Yes

No

Does your child have any medical conditions that we need to be aware of? *

Yes

No

Does your child have any allergies that we need to be aware of? *

Yes

No

Does your child have mental or emotional needs that we that we need to be aware of? *

Yes

No

Has your child been baptized? *

Yes

No

What are some things that your child likes to do for fun? *

Is there anything else you would like us to know about your child?