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.
Clear selection
Today's Date
MM
/
DD
/
YYYY
Clear selection
Submit
Never submit passwords through Google Forms.
This form was created inside of Urban Light Ministries Incorporated. Report Abuse