Orchard Christian Fellowship
6th Grade through 12th Grade Registration Form 132 Pillsbury Rd, Londonderry NH 03053
Parental Consent and Medical Authorization Release
Parents and legal guardians of minor children are asked to complete this form and return it to the church. The information requested is designed to assist the church in providing for the safety of minors during church-sponsored activities.

Student
Student's full name *
Your answer
Student Cell Phone #
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Grade Entering *
Your answer
Student's Address *
Your answer
Family Home Church (if any)
Your answer
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