St. Martin's Episcopal Church | Grade School Registration

Child's Name*

First Last

Gender*

Birth Date*

Grade as of Fall 2014*

Age*

Parent/Guardian Name*

First Last

Parent/Guardian Name

First Last

Preferred Phone*

Preferred Email*

Address*

Street Address City State / Province / Region ZIP / Postal Code

Food Allergies

Photography Release*

Consent for child's photo to be used in occasional St. Martin's Episcopal Church publications. Children's name tags are always blurred.

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