3-year-old thru 6th Grade registration

Student's Last Name: *

Student's First Name: *

Male or Female: *

Male

Female

Student Birthdate: *

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School: *

School that student is attending in the fall

Allergies/Special needs: Please list your student's allergies and/or special needs:

Children's Choir: All students in grades 2 thru 6 are invited to sing with our Children's Choir. Rehearsals are on Wednesday afternoons. Would the above student like to participate in our Children's Choir?:

Yes

No

Parent(s)/Guardian(s) name(s): *

Parent/Guardian address: *

Street Address, City, Zip code

Parent/Guardian Phone: *

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Phone: *

Home

Cell

Parent/Guardian email: *

Church Service: *

8:45am

10:30am

Parent/s sing in the choir

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Membership: Parent/Guardian relationship to the church: *

Member

Prospective Member

Visitor

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In which of the following areas are you willing to volunteer? Check all that apply: *

Teacher

Guide

Help with special projects

I will help wherever needed

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If you have additional comments or instructions add them here:

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