Neelsville Sunday School Registration
Please fill out a registration for each child entering our Sunday School program from age 3 to Grade 6.
Child's First and Last Name
Your answer
Child's Birthdate
Please include day, month, and year
Your answer
Child's Current Grade level for 2017-2018
If child is 3 or 4 years old please select "pre-school."
First Parent or Guardian First and Last Name
Your answer
First Parent's Phone Number
Your answer
Can this number receive texts from our ministry?
First Parent's E-mail address
Your answer
Second Parent or Guardian First and Last Name
Your answer
Second Parent's Phone Number
Your answer
Can this number receive texts from our ministry?
Second Parent's Email Address
Your answer
Mailing Address
Your answer
Emergency Contact Number in case parents cannot be reached
Your answer
Name and relationship of Emergency Contact
Example: Josephine Wen Grandmother
Your answer
Allergies
Please state "None" or the specific allergies your child has. If your child carries an epi-pen please speak with Jamie Swope, the director, to make a plan.
Your answer
Other Medical Concerns
Please state "none" if your child does not have any medical concerns to be noted by our Sunday School teachers and staff.
Your answer
Please list anything else that would be helpful for us to know about your child.
This could include any needs your child may have that would help us best minister to him or her. You can write "none."
Your answer
What adults (besides parents) have permission to pick up your children after Sunday School?
Your answer
Where will the parent typically be during the 9:30 Sunday School hour?
Parents or guardians are required to be on campus during the Sunday School hour.
I agree to my child's photos being used in newsletters, promotional tools like brochures, social media, or other uses deemed appropriate by Neelsville Church.
I agree to not bring my child to Sunday School when he or she has had a fever of 100 degrees or higher or other illness symptoms within 24 hours. Symptoms include vomiting, excessive coughing, snotty nose for reason other than allergies, head lice, conjunctivitis (eye infection), unexplained rash, etc.
I agree that myself or the other parent or guardian or other responsible adults listed on this form will pick up our child promptly after first service ends.
Visiting and connecting with our church family is encouraged AFTER picking up your children.
I agree that a parent or guardian will be on campus at Neelsville during Sunday School time.
I give permission for Neelsville volunteers to call emergency personnel and give appropriate treatment for my child in the event I cannot be reached during a medical emergency. I understand that I, the parent or guardian, has financial responsibility and liability for my child's illnesses or injury incurred on site at Neelsville Church.
Please type the full name of the person who has completed this online registration form and date as your electronic signature. By doing so, you confirm that all of the information you have provided and agreed to is true.
First name Last name Date
Your answer
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