Child's Name* First Last Gender*MaleFemaleBirth Date* Date Format: MM slash DD slash YYYY Grade as of Fall 2014*Kindergarten1st2nd3rd4th5thAge*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 AllergiesPhotography Release*YesNoConsent for child's photo to be used in occasional St. Martin's Episcopal Church publications. Children's name tags are always blurred.Verify This iframe contains the logic required to handle Ajax powered Gravity Forms.
