Medical Information Form

Child's Name *
Child's Name
Date of Birth *
Date of Birth
Purpose and Extent
Fairview Baptist Church is collecting and retaining this personal information for the purpose of enrolling your child in our program(s), to assign the student to the appropriate class, to develope and nurture ongoing relationships with your child, and to inform you of program updates and upcoming opportunities at our church. This information will be maintained indefinitely as it is a requirement of our insurance company and legal counsel. If you wish Fairview Baptist Church to limit the information collected, or to view your child's information, please contact us. (705) 324-6054. *