Sonshine Club Registration
Student's Name *
School Child Attends *
Grade *
Child's Teacher
Home Address
Parent/Guardian Name
Home Phone
Cell Phone *
Email Address *
Other Contact Name - for emergency purposes
Other Contact Phone
Any allergies or medical conditions
How will your child get home?
Other than the above Parent/Guardian, who else is authorized to pick up your child?
You may contact me with information on other Urban Light Ministry programs.
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Today's Date
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