RBC Student Ministries Registration 2016-2017

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Please fill out a separate form for each child. At the end of the form, you can check the boxes for all the student ministries that you are registering your child for.

*Privacy policy: For the security of your personal information, the data collected will only be accessed by our Full Time Elder, Sunday School Superintendent, and Registrar. It will always be password protected and will not be made available to third parties.

Last name of child *

First name of child *

Age of child *

Entering grade at school *

Parent(s) Names *

Home Address *

Please include city and zip code

Parent E-mail Address *

For purposes of communicating important Sunday School information

Parent Cell Phone # *

For emergency contact

Please list any allergies or physical restrictions