New Child/Family Registration | Freedom Church Lockport

Parent/Guardian Name (Required)

Relationship to Child (Required)

Mother

Father

Grandparent

Guardian

Parent/Guardian Phone Number (Required)

Parent/Guardian Email (Required)

Family Address (Required)

Child 1 Name (Required)

Child 1 DOB (Required)

Child 2 Name

Child 2 DOB

Child 3 Name

Child 3 DOB

Child 4 Name

Child 4 DOB

Child 5 Name

Child 5 DOB

Child 6 Name

Child 6 DOB

Do any children have allergies or medical concerns? (Required)

Please list any allergies or medical concerns and take care to name the child these apply to.

Solve 9 + 2 = ?

OUR MISSION

Reach the Lost. Disciple the Found. See Lives Set Free and Stay Free in Jesus Christ.

OUR LOCATIONS

5676 Beattie Ave.

339 Ontario St.

PO Box 1212 Lockport, NY 14094-5