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Family Registration
2022-2023 | All Programs
Child/Youth Info
Please add each child or youth in your family.
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Parent 1
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Phone
*
Email
*
Parent 2
Name
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Last
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Phone
Email
Parent Service Opportunities
Sunday in-person helper
Wednesday Family Night helper
Summer Arts Camp (June)
Special events
Missions projects
Digital communication
I would like more information about:
Baptism
Confirmation
Sunday School curriculum
Godly Play
Wednesday Family Night
Adult formation
Missions/outreach
Events
Photo Release
*
I, as parent or legal guardian of the child(ren) named above, give my permission for photographs and videos of my child(ren) to be used on the Saint Barnabas website at www.saintbarnabas.org, Saint Barnabas Facebook and/or Instagram page, newsletter, and other printed/digital publications for no purpose except that of promoting the life and community of Saint Barnabas Episcopal Church.
Yes, I agree.
No, I do not agree.
Yes, for music performances only.
Electronic Signature
*
I certify that by typing my name below in the Electronic Signature Field and submitting this form, I intend to sign this document and be bound to the same extent as if I had provided a physical signature.
Name
*
First
Last
Preferred Name
Program Registration
*
Check all options that your child might possibly attend. Music and 3M are both at 5:30 on Wednesdays. Please select one or the other.
Sunday School (all ages)
Nursery (infants and toddlers)
Children's Chapel (3-12 years)
Wednesday Music (choir and Music Makers)
Wednesday 3M: Meditation, Movement, Making
JAM (4-7th grade youth group)
Confirmation (7-9th grade)
High School Youth Group (9-12th grade)
Gender
*
Male
Female
Prefer not to answer
Birth Date
*
MM slash DD slash YYYY
Grade
*
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Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
School
Allergies
Dietary Restrictions
Physical Activity Restrictions
Additional Information
Please share with us any information regarding your child's medical, learning, or behavioral challenges so that we may better serve you and your child. Information will only be released on a need-to-know basis to teachers or Saint Barnabas staff.