Child Information
Please fill out a separate form for each child. Information submitted here will be sent to Lori Phelps, Children's Ministry Director at First Presbyterian Church in Waunakee. If you have questions, Lori can be reached by email at lphelps@myfpc.org or by phone at (608) 849-4625.
Email address *
Child's LAST Name *
Your answer
Child's First Name *
Your answer
Birth date
MM
/
DD
/
YYYY
Grade *
School
Your answer
Child's Home Address
Your answer
Food Allergies/Restrictions (including vegetarian/vegan/intolerances, etc.) *
Your answer
Medication Allergies *
Your answer
Medications/Conditions (please list all medications participant is currently taking) *
Your answer
Is there any other information that we should know about your child?
Your answer
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