AGAPE Family Registration Form

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AGAPE seeks to provide connection, fellowship, and faith-based opportunities for our Church’s youngest children, from birth to pre-school age, as well as for their parents and families.

We hope you will join us!

For more information or any questions, reach out to:

Advisor: Anna Jervinis, akjervinis@gmail.com

Email *

Child(ren)’s Name(s): *

Age(s):
*

Parents Name(s):
*

Parent Email Address(es):
*

Parent Phone Number(s):

What is the best way to reach you?

Text

Phone Call

What town do you live in?

Do you or your child(ren) have any food allergies?

What AGAPE events would you be interested in? (Check any)

Play Dates (songs/crafts and free play)

Park Visit

Family Service Project

Fall Festival (apple or pumpkin picking)

Toddler time at a trampoline park

Trolley Museum

Library Visit

Zoo Visit

Other:

How often would you want to meet?

Every other Month

Quarterly

Clear selection

Want to be more involved?

Host a play date

Be a co-advisor for AGAPE

Thanks for asking, but I have (a) young child(ren), I don’t even have time to get enough sleep! :)

Other:

A copy of your responses will be emailed to the address you provided.

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