St. Nicholas Church School — Registration Form
Church School Registration
Each family completes ONE form for the entire family. You may register up to four children. When you submit, you'll get an email with a copy of your answers and a link to edit and resubmit anytime (e.g., next year).
Academic Year
Please Select
2026-2027
Is this a
New Family
Returning Family
Number of children you are registering
Please Select
1
2
3
4
Family Information
Family Last Name
Parent / Guardian 1 Full Name
First Name
Last Name
Parent / Guardian 1 — Relationship
Please Select
Mother
Father
Other, place in notes
Parent / Guardian 1 — Mobile Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Parent / Guardian 1 — Email
example@example.com
Parent / Guardian 2 — Full Name
First Name
Last Name
Parent / Guardian 2 — Mobile Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Parent / Guardian 2 — Email
example@example.com
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you members in good standing of St. Nicholas GOC?
Yes
No
New to Parish
Children (Child # 1)
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gender
Female
Male
Church School Grade (this year)
Please Select
Preschool (3–4 yrs)
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Baptismal (Christian) Name
Name Day
Allergies / Medical conditions
Medications
Children (Child # 2)
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gender
Female
Male
Church School Grade (this year)
Please Select
Preschool (3–4 yrs)
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Baptismal (Christian) Name
Name Day
Allergies / Medical conditions
Medications
Children (Child # 3)
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gender
Female
Male
Church School Grade (this year)
Please Select
Preschool (3–4 yrs)
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Baptismal (Christian) Name
Name Day
Allergies / Medical conditions
Medications
Children (Child # 4)
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gender
Female
Male
Church School Grade (this year)
Please Select
Preschool (3–4 yrs)
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Baptismal (Christian) Name
Name Day
Allergies / Medical conditions
Medications
Emergency Information
Emergency Contact (other than parents) — Name
First Name
Last Name
Emergency Contact — Relationship
Emergency Contact — Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Family Physician — Name
Physician — Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Hospital
Medical Insurance Provider
Emergency medical consent: If I cannot be reached in an emergency, I authorize St. Nicholas Church School to secure emergency medical treatment for my child(ren).
I agree
Photo / Media release: I permit photos/videos of my child(ren) taken at Church School events to be used on the Church School website and media.
Yes
No
Last part
Comments or special requests
I'd like to help with Church School
Yes
Not this year
Maybe, can we discuss?
Signature of Parent / Guardian
Save
Submit Registration
Should be Empty: