Please register your child by submitting the information requested below.
Child's Name
Parent/Guardian's Name
Street Address
Mailing Address (if different)
Phone (home)
Phone (work)
Phone (cell)
EMERGENCY CONTACT NAME
EMERGENCY PHONE
Email Address
Child's Birthdate
Grade just completed:
Medical or other info that we need to know (e.g., allergies?):
Dismissal Information:
Who may pick up your child at the end of each evening's session (IF other than parent)?
Other Information:
Does your child attend Sunday School? If so, where?
If your child is visiting us, who is he a guest of?
May we have permission to photograph your child? (yes/no)
May we have permission to use your child's photograph for the purpose of promotion? (yes/no)
Thank YOU!
Call & Text: 