Regiser Your Child

We’re excited to get to know you and your child. Fill out this form for each child that will be attending our programming. If you have more than one child to register, please come back to this page to fill out the form for each child.

Children & Youth Registration

Child's Name(Required)

First Last

Child's Birthdate(Required)

Has your child been baptized?(Required)

Yes

No

What school does your child attend?(Required)

If your child has any allergies or special needs, please let us know about those.

Address(Required)

Street Address Address Line 2 City State ZIP Code

Parent/Guardian Name 1(Required)

First Last

Parent/Guardian Name 2(Required)

First Last

Parent/Guardian Phone(Required)

Parent/Guardian Email(Required)

Which of the following are you interested in?

Formation

Children's Chapel

Special Events

Youth Group

Is there anything else we should know about this child?

Media Consent(Required)

Sometimes we like to take photos and videos for social media, website, or print materials, and these photos and videos may include your child. If you would like to opt out of having your child appear in these photos or videos, please fill out our opt-out form here.

I understand the Christ & St. Luke's media policy

Would you like to receive email updates from Christ & St. Luke's?

Yes, please

No, thank you

Children & Youth Registration

Regiser Your Child

Children & Youth Registration

Worldwide Anglican Communion

Episcopal Church in the USA

Episcopal Diocese of Southern Virginia

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