BelPres Family Registration

Please remember to add an accurate phone number to parent contact information. If not provided or not correct, you may not be able to check your child in on Sunday mornings.

Question Title

* 1. We are:

New to BelPres

Adding a new member to the family

Updating address, email, or phone number

Other

Question Title

* 2. Please provide contact information for Parent/Guardian 1

Name

Relationship to Child

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number (required)

Question Title

* 3. Please provide contact information for Parent/ guardian 2

Name

Company

Address (if different from Parent/Guardian 1)

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number (required)

Question Title

* 4. Photo/video release: If you do not want photos obtained during church activity to be featured in future church publications, please request a Photo/Media Opt Out Form and submit with a current photo of your child.

I understand

Question Title

* 5. Child #1

Child's Full Name

Nickname (on nametag)

Gender

Date of Birth

Grade

Allergies

Question Title

* 6. Child #2

Child's Full Name

Nickname (on nametag)

Gender

Date of Birth

Grade

Allergies

Question Title

* 7. Child #3

Child's Full Name

Nickname (on nametag)

Gender

Date of Birth

Grade

Allergies

Question Title

* 8. Child #4

Child's Full Name

Nickname (on nametag)

Gender

Date of Birth

Grade

Allergies

Question Title

* 9. Child #5

Child's Full Name

Nickname (on nametag)

Gender

Date of Birth

Grade

Allergies

Question Title

* 10. Child(ren) Live With:

Both Parents

Mother

Father

Split Time

Other