Foundations Registration 2008-2009

Date:
* Husband's Name:  * Wife's Name:  * Last Name:
* Email Address:  (One you check frequently)
* Street Address:
* City:
* State:
* Zip Code:
Telephone:
Husband's Cellphone:
Wife's Cellphone:
Please list your children's names and their ages:
	> 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
	> 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
	> 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
	> 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
	> 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
	> 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
	> 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
	> 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Help us serve you better by providing some more information about your family:
Current Church Home:
Homeschool Church School Affiliation:
Hope Christian School Heritage Academy SMI Academy Crossroads Christian School Evangel Christian School Lighthouse Academy Other:
Homeschool Interest/Experience	Investigating Home Education Preparing - Our Children are Pre-School First Year Second Year Three Years Four Years Five or more Years
How did you hear about Foundations:	Website Church Referred by Friend (Please input below) Other (Please input in Comments below)
Referred By:
How long have you been in Foundations:	First Year Second Year Three Years Four Years Five or more Years
Areas of Interest:	Field Trips  Monthly Seminars  Ebenezer Couples  Bright Arrows  Fellowship/Relationships  Other
Comments:
	We give permission for our contact information to be published for Foundations Members in a Member Directory:
We/I agree to hold the leadership and members of Foundations, a voluntary home school resource group for parents, harmless from all liability for any reason whatsoever resulting from or arising out of my relationship with this group and our attendance at meetings and field trips. Our children are listed above this Waiver.
Yes, We Agree
* required field