2016-17 Third Presbyterian Church Children's Ministry Registration Form
Please use this form to register your children for the 2016-2017 Program Year.
You can register up to 4 children for Sunday School and Qabats with just one form!

Families who register for Qabats will receive additional information at a Qabats parent meeting to be held on Wednesday, September 14th during the first Wednesday evening Junior Choir rehearsal.. Please note that Qabats begins on Wednesday, October 5, and continues through the end of March. The Glorious Voices and the Junior Choir meet as part of the Qabats program. Families participating in Choir will receive additional information at their first rehearsal on Rally Day, September 11 at 9am.

For any additional questions, please contact Becky D'Angelo-Veitch at rveitch@thirdpresbyterian.org or 271-6537 ext. 118 or Mary Ann Rutkowski at mrutkowski@thirdpresbyterian.org or 271-6537 ext. 101.

Household Information
Family Name
ex. Smith
Your answer
Parent(s) Name(s)
First name(s). Include last name only if different from family name.
Your answer
Address
ex. 4 Meigs Street, Rochester, NY 14607
Your answer
Phone Number
ex. 555-867-5309
Your answer
Household e-mail address
We use e-mail as our primary means of communication including: children's ministry newsletters, information on special events and emergency cancellations
Your answer
Child #1
Please complete the following information on your oldest child in the Children's Ministry program (up to sixth grade)
Child #1 Name
"Jane" or "Jane Doe" if child has a different last name
Your answer
Child #1 Birthday
MM/DD/YYYY
Your answer
Child #1 Grade for 2016-2017 year
Child #1 - Any allergies/conditions we should be aware of?
Food Reactions, Physical Limitations, ADD/ADHD, or None
Your answer
Child #1 - Do you want to sign up for Qabats?
Qabats is our Wednesday evening program for children in 1st -6th grade. As part of the Qabats program, 1st & 2nd graders sing in the Glorious Voices, and 3rd-6th graders sing in the Junior Choir. Please note there is a fee for Qabats which primarily pays for meals. YOUTH AND QABATS FEES ARE COMBINED! This year's fee is $75 for 1 child, $135 for 2 children, and $190 for 3+ children. This fee covers all children in your family in the youth and/or Qabats programs. If you register for Qabats, please remember to bring a check for your $35 deposit on Rally Day.
Child #1 - Do you want to sign up for Children's Bell Choir? (5th and 6th graders only)
Rehearsals are Wednesdays from 5:00-5:30pm on days when Qabats meets.
Child #2
Please complete the following information on your next oldest child in the Children's Ministry program (up to sixth grade) if applicable.
Child #2 Name
"Jane" or "Jane Doe" if child has a different last name
Your answer
Child #2 Birthday
MM/DD/YYYY
Your answer
Child #2 Grade for 2016-2017 year
Child #2 - Any allergies/conditions we should be aware of?
Food Reactions, Physical Limitations, ADD/ADHD, or None
Your answer
Child #2 - Do you want to sign up for Qabats?
Qabats is our Wednesday evening program for children in 1st -6th grade. As part of the Qabats program, 1st & 2nd graders sing in the Glorious Voices, and 3rd-6th graders sing in the Junior Choir. Please note there is a fee for Qabats which primarily pays for meals. YOUTH AND QABATS FEES ARE COMBINED! This year's fee is $75 for 1 child, $135 for 2 children, and $190 for 3+ children. This fee covers all children in your family in the youth and/or Qabats programs. If you register for Qabats, please remember to bring a check for your $35 deposit on Rally Day.
Child #2 - Do you want to sign up for Children's Bell Choir? (5th and 6th graders only)
Rehearsals are Wednesdays from 5:00-5:30pm on days when Qabats meets.
Child #3
Please complete the following information on your next oldest child in the Children's Ministry program (up to sixth grade) if applicable.
Child #3 Name
"Jane" or "Jane Doe" if child has a different last name
Your answer
Child #3 Birthday
MM/DD/YYYY
Your answer
Child #3 Grade for 2016-2017 year
Child #3 - Any allergies/conditions we should be aware of?
Food Reactions, Physical Limitations, ADD/ADHD, or None
Your answer
Child #3 - Do you want to sign up for Qabats?
Qabats is our Wednesday evening program for children in 1st -6th grade. As part of the Qabats program, 1st & 2nd graders sing in the Glorious Voices, and 3rd-6th graders sing in the Junior Choir. Please note there is a fee for Qabats which primarily pays for meals. YOUTH AND QABATS FEES ARE COMBINED! This year's fee is $75 for 1 child, $135 for 2 children, and $190 for 3+ children. This fee covers all children in your family in the youth and/or Qabats programs. If you register for Qabats, please remember to bring a check for your $35 deposit on Rally Day.
Child #3 - Do you want to sign up for Children's Bell Choir (5th and 6th graders only)?
Rehearsals are Wednesdays from 5:00-5:30pm on days when Qabats meets.
Child #4
Please complete the following information on your next oldest child in the Children's Ministry program (up to sixth grade) if applicable.
Child #4 Name
"Jane" or "Jane Doe" if child has a different last name
Your answer
Child #4 Birthday
MM/DD/YYYY
Your answer
Child #4 Grade for 2016-2017 year
Child #4 - Any allergies/conditions we should be aware of?
Food Reactions, Physical Limitations, ADD/ADHD, or None
Your answer
Child #4 - Do you want to sign up for Qabats?
Qabats is our Wednesday evening program for children in 1st -6th grade. As part of the Qabats program, 1st & 2nd graders sing in the Glorious Voices, and 3rd-6th graders sing in the Junior Choir. Please note there is a fee for Qabats which primarily pays for meals. YOUTH AND QABATS FEES ARE COMBINED! This year's fee is $75 for 1 child, $135 for 2 children, and $190 for 3+ children. This fee covers all children in your family in the youth and/or Qabats programs. If you register for Qabats, please remember to bring a check for your $35 deposit on Rally Day.
Do you want to sign up for Children's Bell Choir? (5th and 6th graders only)
Rehearsals are Wednesdays from 5:00-5:30pm on days when Qabats meets.
The final stretch. . .
Emergency information, volunteer opportunities and feedback. . .
Emergency Contact
helpful for all, but only mandatory for families participating in Qabats
Your answer
Emergency Contact Phone Number
ex. 555-867-5309
Your answer
I can help in Sunday School as a
Required
Submitted by
Your answer
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