2018-2019 Sunday School Registration
Registration information for 2018-2019. Please fill out one form for each child being registered.
Student's Name (last, first) *
Your answer
Student Birth date *
MM
/
DD
/
YYYY
Grade entering Fall 2018 *
Parent/Guardian Name (1) *
Your answer
Parent/Guardian Name (2)
Your answer
Address *
Your answer
Cell Phone Number *
Your answer
Home Phone Number
Your answer
May we send you text messages? *
Email *
Your answer
Church Membership *
Where can you be reached during the Sunday School hour? *
Your answer
Are there any health related issues the teacher(s) should know about? (Allergies, activity restrictions, etc)
Your answer
Dietary restrictions *
Are there any other adults who have permission to pick up your child(ren)? (Please list names)
Your answer
Primary Insurance (name of insurance, policy #, group #, policy holder name, DOB, employer) or bring a copy for the file
Your answer
Secondary Insurance if applicable (name of insurance, policy #, group #, policy holder name, DOB, employer)
Your answer
Doctor (name and phone #)
Your answer
Hospital Preference *
Your answer
Emergency Contact (beside parents) and phone # *
Your answer
St. Luke's Sunday School would like to have your permission to photograph/videotape your child(ren) for use in various ways to promote fellowship, fun and our Sunday school. I.E. photos may be used in class, on bulletin boards, flyers, or on Facebook. *
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