Church school registration

Family's Last Name (or Names)*
Parent/Guardian Name 1*
Address
Street Address City State ZIP Code
Mobile*
Preferred Email*
Talents/Hobbies/Skills to Share
Parent/Guardian Name 2
Address
Street Address City State ZIP Code
Mobile
Preferred Email
Talents/Hobbies/Skills to Share
Child Name 1*
Date of Birth*
Date Format: MM slash DD slash YYYY
Grade Level in Fall 2019*
Mobile
Preferred Email
Child Name 2
Date of Birth
Date Format: MM slash DD slash YYYY
Grade Level in Fall 2019
Mobile
Preferred Email
Child Name 3
Date of Birth
Date Format: MM slash DD slash YYYY
Grade Level in Fall 2019
Mobile
Preferred Email
Child Name 4
Date of Birth
Date Format: MM slash DD slash YYYY
Grade Level in Fall 2019
Mobile
Preferred 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.
Emergency 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?

Church School Registration