Church school registration

Family Name*
Preferred Email*
Parent/Guardian Name 1*
Mobile*
Talents/Hobbies/Skills to Share
Parent Guardian Name 2
Address
Street Address City ZIP / Postal Code
Mobile
Talents/Hobbies/Skills to Share
Child Name 1*
Date of Birth*
Date Format: MM slash DD slash YYYY
Grade Level*
Child Name 2
Date of Birth
Date Format: MM slash DD slash YYYY
Grade Level
Child Name 3
Date of Birth
Date Format: MM slash DD slash YYYY
Grade Level
Child Name 4
Date of Birth
Date Format: MM slash DD slash YYYY
Grade Level
Any medical dietary or family info that the Teacher should know?*
- Yes.
- No.
Which?
- I give permission to allow pictures and videos of my child to appear in publications and/or on our website.
- I do not give permission for pictures or videos of my child to appear in publications or on the website.
Emergency contact name*
Relationship to Child*
Mobile*

Church School Registration