Parent Information

Parent/Guardian 1

First Name:
Last Name:
Cell Phone:
Email:

Parent/Guardian 2

First Name:
Last Name:
Cell Phone:
Email:

Household

Address Line 1:
Address Line 2:
City:
Province:
Postal Code:
Home Phone:

Child Information

You may add additional children by clicking "+ Add Child".

Child 0

First Name:
Last Name:
Gender:	M F
Birthdate:
Grade:
Anything else we should know about this child?:

Photo & Video Usage

From time to time, QBC may wish to use photos and videos of your children without identifying information on photo slide shows, bulletin boards, flyers, the QBC website, etc. We do this to give a personal touch to our communication and to celebrate what God is doing in our ministry. Note: We reserve the right to use photos without permission where your children are not distinguishable, such as photos in which they are part of a group.

Yes, QBC may use photos/videos of my/our children without identifying information
No, QBC may not use photos/videos of my/our children