Child/Family Registration Parent/Guardian Name 1 * First Name Last Name Relationship to Child(ren) * Parent/Guardian Name 2 First Name Last Name Relationship to Child(ren) Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Cell Phone * (In case of emergency) (###) ### #### Child Name (1) * First Name Last Name Date of Birth Grade PreK K !st Grade 2nd Grade 3rd Grade 4th Grade 7th - 12th Grade Child Name (2) First Name Last Name Date of Birth Child Name (3) First Name Last Name Date of Birth Grade PreK K !st Grade 2nd Grade 3rd Grade 4th Grade 7th - 12th Grade Child Name (4) First Name Last Name Date of Birth Grade PreK K !st Grade 2nd Grade 3rd Grade 4th Grade 7th - 12th Grade How did you hear about Westlake Church? Text Thank you!
