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FCC Kidz Registration
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* Indicates required question
Email
*
Your email
Parent/Guardian Name 1
*
Your answer
Street Address
*
Your answer
Mobile Phone
*
Your answer
Preferred Email
*
Your answer
Talents/Hobbies/Skills to Share
Your answer
Parent Guardian 2
Parent/Guardian Name 2
Your answer
Address if different from above
Your answer
Preferred Email
Your answer
Mobile Phone
Your answer
Talents/Hobbies/Skills to Share
Your answer
Child 1
Child Name 1
*
Your answer
Child 1 Date of Birth
*
MM
/
DD
/
YYYY
Grade Level Fall 2021
*
Preschool
Y5
K
1
2
3
4
5
6
7
8
9
10
11
12
Preferred E-mail
Your answer
Mobile Phone if different from above
Your answer
Child 2
Child Name 2
Your answer
Child 2 Date of Birth
MM
/
DD
/
YYYY
Child 2 Grade Level Fall 2021
Preschool
Y5
K
1
2
3
4
5
6
7
8
9
10
11
12
Clear selection
Mobile Phone if different from above
Your answer
Preferred E-mail
Your answer
Child 3
Child Name 3
Your answer
Child 3 Date of Birth
MM
/
DD
/
YYYY
Child 3 Grade Level Fall 2021
Preschool
Y5
K
1
2
3
4
5
6
7
8
9
10
11
12
Clear selection
Child 4
Child Name 4
Your answer
Child 4 Date of Birth
MM
/
DD
/
YYYY
Child 4 Grade Level Fall 2021
Preschool
Y5
K
1
2
3
4
5
6
7
8
9
10
11
12
Clear selection
Mobile Phone if different from above
Your answer
Preferred Email
Your answer
Important Information
Any medical, dietary, or family information the teacher should know?
*
Yes
No
Required
If yes, please explain.
Your answer
Photo Release
*
I give permission to allow pictures and videos of my child to appear in publications and/or on The First Congregational Church of Ann Arbor's website and social media.
I DO NOT give permission to allow pictures and videos of my child to appear in publications and/or on The First Congregational Church of Ann Arbor's website and social media.
Emergency Contact
Emergency Contact Name
*
Your answer
Relationship to Child
*
Your answer
Mobile Phone
*
Your answer
Communications
I would like to receive weekly FCC Kidz updates
*
Yes
No
If yes, please provide an email address.
Your answer
I would like to receive church-wide email communications
*
Yes
No
If yes, please provide an email if different from above
Your answer
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