2019-2020 Registration Form
Email *
Student's Name *
Nick Name
Birth Date *
MM
/
DD
/
YYYY
Grade *
Gender *
Allergies
Physician's Name
Physician's Phone Number
Is there any other information that will help us when working with your student?
Parents’/Guardians’ Names *
Home Address *
Cell Numbers
Other Adults Authorized to Pick Up Student
By typing my name in this form below, I give my consent for my student listed above to participate in activities with First United Methodist Church (FUMC). I understand some events include transportation in vehicles driven by pre-screened adults. If my child is injured, I authorize FUMC to provide appropriate medical treatment up to and including a visit to a hospital if needed, and I understand I will be responsible for any treatment costs. I understand that photos of my student may be used to celebrate and promote events within the church, and may be posted online in formats such as Facebook and the FUMC website. *
Please type your full name here
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