Central Reformed Church STARS
Student's Education & Activity Registration Form
First Name of Child 1
Last Name of Child 1
Birth Date (mm/dd/yyyy)
School Grade (Current)
Child 1 will participate in:
Children in Worship (4 years old - Kindergarten)
Pre-school (3 years old - Pre-school) Sunday School
Elementary (Kindergarten-6th grade) Sunday School
Junior High (7th-8th grade) Sunday School
Senior High (9th-12th grade) Sunday School
LOGOS (Kindergarten-6th grade)
Junior High FOCUS (7th-8th grade)
Senior High CHAOS (9th-12th grade)
Please list the child Insurance Policy Number. (if it is the same as your Family Insurance Number please leave blank)
Does this child have specific needs and/or allergies, that may need special attention, if needed?
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