StPaulsSundaySchool

How many children are you registering? (All children 3 years old to teens are welcome.) *
Child Information
First Child
Child's Name *

First Name Last Name
Child's Birth Date *

Month Day Year
Last Grade Completed *
Does the child attend Church anywhere? *

Yes No
Where?
Medical or other information we may need to know about the child (including food allergies). *
Second Child
Child's Name *

First Name Last Name
Child's Birth Date *

Month Day Year
Last Grade Completed *
Does the child attend Church anywhere? *

Yes No
Where?
Medical or other information we may need to know about the child (including food allergies). *
Third Child
Child's Name *

First Name Last Name
Child's Birth Date *

Month Day Year
Last Grade Completed *
Does the child attend Church anywhere? *

Yes No
Where?
Medical or other information we may need to know about the child (including food allergies). *
Fourth Child
Child's Name *

First Name Last Name
Child's Birth Date *

Month Day Year
Last Grade Completed *
Does the child attend Church anywhere? *

Yes No
Where?
Medical or other information we may need to know about the child (including food allergies). *
Child Release Information
Parent/Legal Guardian Name *

First Name Last Name
Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Names of Persons to which the child (children) may be released to each day after Sunday School (Please provide at least two) *

First Name Last Name
Full Name *

First Name Last Name
Full Name

First Name Last Name
Full Name

First Name Last Name
Are there any persons to which the child (children) may NOT be released to? *

Yes No
Who may your child (children) NOT be released to?
Emergency Contact 1 (other than parent/guardian listed above) *

First Name Last Name
Emergency Contact 1 Phone Number *

Area Code Phone Number
Emergency Contact 2 (other than parent/guardian listed above) *

First Name Last Name
Emergency Contact 2 Phone Number *

Area Code Phone Number
Media Release
By clicking the box below, I hereby Give Permission for photographs and/or video in which my child appears in to be used by the church in printed and/or electronic media, including the church's website.

I Agree
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Child Information

First Child

Second Child

Third Child

Fourth Child

Child Release Information

Media Release