If we do not have your current contact information, please e-mail bernadette@calvaryb.org with updated information.

Name *
Name
Date of Birth
Date of Birth
Contact Phone
Contact Phone
Work Phone
Work Phone
Home Address
Home Address
Spouse Name
Spouse Name
Spouse DOB
Spouse DOB
Child 1
Child 1
Child 1 DOB
Child 1 DOB
Child 2
Child 2
Child 2 DOB
Child 2 DOB
Child 3
Child 3
Child 3 DOB
Child 3 DOB
Child 4
Child 4
Child 4 DOB
Child 4 DOB
Child 5
Child 5
Child 5 DOB
Child 5 DOB
By providing this information I grant to Calvary Baptist Church, its representatives and employees the right to take photographs of me and my family with or without my name for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content.