Panama United Methodist Sunday School

Panama United Methodist Sunday School
Information and Photo Release Form
Child's Name
Person registering child
Parent/Guardion Name
(PO Box)
(Street)
(City)
State
Zip
Email
example@example.com
Phone Number to reach in case of emergency during Sunday School
Please enter a valid phone number.Format: (000) 000-0000.
Allergies/Health conditions or concerns
EMERGENCY CONTACTS
Name #1
Phone
Format: (000) 000-0000.
Name #2
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
DISMISSAL INFORMATION
Name(s) of person(s) (other than names above) who may pick up this child from Sunday School
Name
Phone
Format: (000) 000-0000.
Name
Phone
Format: (000) 000-0000.
PHOTO RELEASE
I give permission to the Panama United Methodist Church (PUMC) of Panama, New York to use photographs and videos taken of my child participating in Sunday School activities for the promotion of Sunday School of PUMC. Check either YES or NO
YESNO
Parent/Guardian Signature
Date

MonthDayYear
Date
Panama
Should be Empty:

EMERGENCY CONTACTS