Barrington Directory Form

If you’re a regular attender at BeFree, we’d like to include you in our directory. Fill out the form below, and check the required box for authorization at the bottom before submission.

You don’t need to fill out this form if you’re a member of BeFree unless you added a family member, or if there are changes to your info.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

If married, please list your anniversary:

YYYY

List info for each family member who attends BeFree:

• Only list cell phone numbers if you want them published in the directory. • Only list email addresses for people who use email.

Name

First Name

Last Name

Birthdate

YYYY

Cell Phone

(###)

###

####

Name

First Name

Last Name

Birthdate

YYYY

Cell Phone

(###)

###

####

Name

First Name

Last Name

Birthdate

YYYY

Cell Phone

(###)

###

####

Directory Authorization

I hereby give permission to publish the above-listed information in the BeFree directory, and to receive occasional information about BeFree to the email address(es) listed above.

I agree

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