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Grapes & Grains Registration Form
Registration for Children Participating in Grapes and Grains Class, Spring 2023
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Email
*
Your email
Please tell us about your child
First name
*
Your answer
Middle name
Your answer
Last name
*
Your answer
What name does your child prefer to be called by?
What pronouns does your child prefer?
Your answer
Street Address
*
Your answer
City, State, Zip
*
Your answer
Age
*
Your answer
Birthday
*
MM
/
DD
/
YYYY
Has your child been baptized?
*
Yes
No
Does your child have any allergies?
*
Choose
Yes
No
If your child has any allergies, please specify:
Your answer
Please share anything else about your child that you think we should know:
Your answer
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