Registration for Family Place- March 27, 2021
Family Place is an online event for children from birth-fifth grade and their parents/guardians. It will be held March 27, 2021 from 4-5:30 pm EDT, 3-4:30 pm CDT, 2-3:30 pm MDT, and 1-2:30 pm PDT.
Contact Details
Youth Participant's First Name
Youth Participant's Last Name
Youth Participant
Youth Participant's Pronouns (optional)
Youth Participant's Date of Birth (MM/DD/YY)
Is this the participant's first time at an FGC program?
Yes
No
Race/Ethnicity
Youth Participant's Primary Ethnicity
Please select...
African descent (Black)
Asian descent
European descent (White)
Hispanic/Latino/a/x descent
Middle Eastern descent
Multi-Racial
Native American / Aboriginal descent
Pacific Islander
None of the above / Other
Decline to Respond
Other Race/Ethnicity
Parent/Guardian Information for ALL YouthParticipants
This section must be completed by parents/guardians for all participants under 18. If you are 18 years old, please fill out with your information.
Parent/Guardian's Name
Parent/Guardian's Pronouns (optional)
Race/Ethnicity
Parent/Guardian's Primary Ethnicity
Please select...
African descent (Black)
Asian descent
European descent (White)
Hispanic/Latino/a/x descent
Middle Eastern descent
Multi-Racial
Native American / Aboriginal descent
Pacific Islander
None of the above / Other
Decline to Respond
Other Race/Ethnicity
FGC-Affiliated Meetings
Meeting Affiliation (Monthly, Yearly, etc.)
Parent/Guardian's Street Address
City
State/Province
Zip/Postal Code
Country
Parent/Guardian's Phone Number
Phone
This is my...
Please select...
Home phone
Work phone
Mobile phone
Parent/Guardian's Email Address
Email
This is my...
Please select...
Personal email
Work email
Do you consent to have the parent/guardian's contact information shared with other participants?
Phone and email
Phone only
Email only
Do not share my contact info with other participants
Have you already reviewed and signed FGC's Online Youth Safety Policy?
Yes
No
FGC's Family Place is provided free of charge. If you'd like to make a financial contribution to support FGC Youth Ministries,
please visit this link
.
Your registration is complete. If you have not yet signed FGC's Online Youth Safety Policy, you will be forwarded to another form to complete it.
Contact Information