Shir Shalom School Registration
Child #1 Name (First & Last)
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Child #1 Age
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Child #1 Grade
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Child #2 Name (First & Last)
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Child #2 Age
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Child #2 Grade
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Child #3 Name (First & Last)
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Child #3 Age
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Child #3 Grade
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Child #4 Name (First & Last)
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Child #4 Age
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Child #4 Grade
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Parent/Guardian #1 Name
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Parent/Guardian #1 Phone Number
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Parent/Guardian #1 Email
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Parent/Guardian #2 Name
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Parent/Guardian #2 Phone Number
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Parent/Guardian #2 Email
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Parent/Guardian #1 Mailing Address
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City
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State
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Zip
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Parent/Guardian #2 Mailing Address (if different than above)
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City
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State
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Zip
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