FCOR - Sunday Registration Form 2020-2021
175 Main Street, Rowley, MA 01969
(978) 948-3993, first.church@verizon.net
www.firstchurchrowley.org
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Student Name (Last Name, First) *
Student Date of Birth *
MM
/
DD
/
YYYY
Student Address (# Street, City, State, Zip) *
Student Primary Email Address *
Student Primary Telephone Number *
*
Required
Status Status (Please Check One) *
Student grade during the 2020-2021 School Year (Pick One) *
Required
Parent #1 Name Telephone Number and Email Address Address (if different than student's) *
Parent #2 Name Telephone Number and Email Address Address (if different than student's) *
Sibling Names and DOB's *
Emergency Contact (Other than Parents) Name | Relationship | Cell *
Does your child have allergies? Write Yes or No. If yes, please list. *
Does your child have sensitivities? Write Yes or No. If yes, please list. *
Does your child require special accommodations? Write Yes or No. If yes, please explain. *
I give the first congregational Church of Rowley permission to take pictures and to use said pictures of my child in any of their publications (including but not limited to (newsletters, bulletins, PR material, social media, etc...) *
Required
Electronic Signature | Date *
By Typing your name and dating the section below, you are giving your child permission to participate in the First Congregational Church of Rowley's Christian ED Programming for the 2020-2021 School Year.
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