Sunday School Registration '23-24

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St. Paul's UCC Minonk

Student Name *

Student Birthday *

YYYY

Student's Grade in School: *

Pre/Kinder

8th grade

Guardian Name(s): *

Phone(s) *

Email(s):

Home Address: *

Medical/Allergy Information:

Preferred Medical Facility:

Name of Doctor/Physician/Pediatrician:

Anything you want us to know about your child?

I, the undersigned, agree with the following statements: *

I am the parent/guardian fot he child indicated above

If emergency medical care is needed and I am unavailable, I authorize the supervising teacher/staff to seek medical treatment for my child

I am giving permission to use pictures of my child and their projects on the church website/social media

Bắt buộc

Type your name to indicate you agree with the statements checked above: *

Gửi

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