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