New Family - Nursery/Children

Parent Name

Parent Email

This address will receive a confirmation email

Parent Phone

Parent Address

Please provide an Emergency Contact Name, Number and relationship to child, in the event you cannot be reached:

Photo Release

Yes, Goochland Baptist Church has my permission to use my child(ren)'s photographs and/or videos publicly. I understand the images/videos may be used in print publications, online publications, presentations, website or social media.n No, I do not give my permission.

Child(ren)'s Name(s)

Date(s) of Birth

Age(s)/Grade Level(s)

Special needs/allergies/medical info/other:

Please list any other helpful information you would like us to know about your child(ren):

Description

Welcome! We are so glad you have decided to visit our church. If you are the guardian of a child you would like to attend our nursery or one of our children's Sunday school classes, please fill out this form completely with your information and information for each child. If you have any questions please contact the church office at office@goochlandchurch.org

New Family - Nursery/Children

Description

Please Fix the Following