Sunday School Registration Form
Child's Name
*
First Name
Last Name
Age
*
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Emergency Contact Name
First Name
Last Name
Relationship
Phone Number
Please enter a valid phone number.
Preferred Medical Facility
Name of Physician/Pediatrician
First Name
Last Name
Phone Number
Please enter a valid phone number.
Any Allergies or Medical Conditions?
*
Yes
No
If yes, please give details
Do you want to add something about your child?
I, undersigned, agree with the following statements:
*
I am the parent/guardian of the child indicated above.
If emergency medical care is needed and I am unavailable, I authorize the supervising teacher to seek medical treatment for my child.
I am giving my permission to take my child's pictures for classroom projects and post them on the church website.
Date
-
Month
-
Day
Year
Date
Signature
*
Print
Submit
Should be Empty: