As Ambassador seeks to serve the families and kids of the church, we are asking that EVERY family complete the following information about their children. The information will be treated with absolute discretion and will only be used to assist the teachers in serving your kids and family. We will also use email to keep you updated about our children’s ministry. If you have any questions, please don’t hesitate to contact Peter Morris by email or by phone: (703) 501-8638.

First Child

1. Child's Name(required)
2. Child's Date of Birth(required)
3. Grade in School(required)
4. Describe any alergies/medications, or behavioral, emotional, or physical issues (if applicable)

Second Child

1. Child's Name (2)
2. Child's Date of Birth (2)
3. Grade in School (2)
4. or behavioral, emotional, or physical issues (if applicable) (2)

Third Child

1. Child's Name (3)
2. Child's Date of Birth (3)
3. Grade in School (3)
4. or behavioral, emotional, or physical issues (if applicable) (3)

Fourth Child

1. Child's Name (4)
2. Child's Date of Birth (4)
3. Grade in School (4)
4. or behavioral, emotional, or physical issues (if applicable) (4)

Parent Information

1. Mother's last name(required)
2. Mother's first name(required)
3. Father's last name(required)
4. Father's first name(required)
5. Street Address (Primary)(required)
6. Street Address (line 2)
7. City/Suburb(required)
8. State(required)
9. Zip(required)
10. Email Address(valid email required)
11. Phone Number(required)

Emergency Information

1. Mother's Cell Number
2. Father's Cell Number
3. Other Cell (state name and relationship)

 

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