Church School Registration Family's Last Name (or Names)*Parent/Guardian Name 1*Address Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Mobile*Preferred Email* Talents/Hobbies/Skills to ShareParent/Guardian Name 2Address Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code MobilePreferred Email Talents/Hobbies/Skills to ShareChild Name 1*Date of Birth* Date Format: MM slash DD slash YYYY Grade Level in Fall 2020*Nursery (0-3 years old)PreschoolYoung 5sKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeMobilePreferred Email Child Name 2Date of Birth Date Format: MM slash DD slash YYYY Grade Level in Fall 2020Nursery (0-3 years old)PreschoolYoung 5sKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeMobilePreferred Email Child Name 3Date of Birth Date Format: MM slash DD slash YYYY Grade Level in Fall 2020Nursery (0-3 years old)PreschoolYoung 5sKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeMobilePreferred Email Child Name 4Date of Birth Date Format: MM slash DD slash YYYY Grade Level in Fall 2020Nursery (0-3 years old)PreschoolYoung 5sKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeMobilePreferred Email Any medical, dietary or family info that the Teacher should know?*Yes.No.Please provide important information.Photo Release*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.Last names of children will not be used in any publication.Permissions*I authorize delivery of program materials.YesNoTimes delivery may be made*Select all time slots that work for you.Noon - 5 p.m. on Tuesday September 8th9 a.m.-Noon on Wednesday, September 9thNoon-5 p.m. on Wednesday, September 9th9 a.m.-Noon on Thursday, September 10thNoon-5 p.m. on Thursday, September 10th6 p.m.-9 p.m. on Thursday, September 10thDelivery Date thatFirst ChoiceSecond ChoiceThird ChoiceSpecial Delivery InstructionsEmergency contact name*Relationship to Child*Mobile*Would you like to receive the weekly Church School News email?Yes.No.What email address(es) would you like the Church School News email sent to?Would you like to receive church-wide email communications?Yes.No.What email address(es) would you like church-wide communications sent to?
