Church School Registration2011-2012
Church School Class/Age Group
Please help our teachers get to know your child better.
Student's Full Name *
Student's Preferred Name
Gender Male Female
Birthday *
(Including Year)
Infants
Toddlers and 2's
Age 3
Age 4
Age 5
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
In which school is the student enrolled?
Which school district?
Address *
Home Phone *
Alternate Address/Phone
Email Address *
Parents' Names *
Yes
No
Interested in Inquirers' Class?
I would like to talk to a pastor about this option.
Please tell us anything we may need to know about your child.
If so, to what?
How would you be willing to help the church school program?
I will pick my child up at the classroom at 10:45 each week.
I would like to meet my child in Chadsey Hall at 10:45.
Other persons authorized to pick up my child:
Children will only be released to parents and those listed here.