Student Registration | glencoefpa.com

top of page

259 Main St.

Glencoe, ON

N0L 1M0

519-287-2448

Untitled

Home
About Us
Past Services
More

Use tab to navigate through the menu items.

Student Registration

Student's Name

School/Grade/Birthdate

Health Card Number

Does your child have any physical, emotional, mental, or behavioural concerns or limitations that our staff should be aware of? If yes, please explain.

Are any siblings attending this program? (Please list)

Parent/Guardian Name(s)

Phone

Which student program will your child be participating in? *

KidZone

I give permission for pictures of my child to be taken and used for Faith Pentecostal student program promotion. *

Yes

No

I give permission for my child to participate in Faith Pentecostal student program activities.

Thank you for registering!

FAITH PENTECOSTAL ASSEMBLY

259 Main St.

Glencoe, ON N0L 1M0

519-287-2448

faithpentecostalassembly@gmail.com

An evangelical church in Southwest Middlesex, with the heart and passion to help each and every person as they connect to God.

© 2021 Faith Pentecostal Assembly (Glencoe)

bottom of page