St. John's Children Registration 2018-2019
St. John's Church is collecting and retaining this personal information for the purpose of serving your Child while in the care of St. John's Church, enrolling your Child in our programs, to assign the student to the appropriate classes, to develop and nurture ongoing relationships with you and your Child, and to inform you of program updates and upcoming opportunities at our organization.

Any medical information collected here serves to authorize St. John's Church staff and volunteers to obtain medical assistance in emergencies.

Email address *
Parent/Guardian Names *
Mailing Address (with city and zip code)
Home Phone
Parent/Guardian Cell Phone(s) *
Parent/Guardian Email(s) *
In Case of Emergency, Contact: *
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