Children’s Pre-registration

Your Name

Your Email

Child 1's Name

Child 1's Birthdate

Child 2's Name (if applicable)

Child 2's Birthdate (if applicable)

Child 3's Name (if applicable)

Child 3's Birthdate (if applicable)

Child 4's Name (if applicable)

Child 4's Birthdate (if applicable)

Address

City

Province

Postal Code

Family Phone #

Cell Phone #

I give Portage Avenue Church permission to contact me via email (approximately 1-2 emails/month)