Sunday School Registration Form

STUDENT'S INFORMATION

Student's Name (Required Field)

Street Address (Required Field)

City/State/Zip (Required Field)

Home Phone Number: (Required Field)

Student's Date of Birth (Required Field)

Please indicate which class your child will be entering this fall: (Required Field)
---Pre-KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade

Please advise age if the child is entering Pre-K:

PARENT/GUARDIAN - (Please enter contact information for both parents, if applicable)

Parent/Guardian Name (Required Field)

Relationship (Required Field)

Parent/Guardian's Cell Phone Number (Required Field)

Parent/Guardian's Email Address (Required Field)

Parent/Guardian's Street Address (if different from student)

Parent/Guardian's City/State/Zip (if different from student)

Additional Parent/Guardian's Name (If Applicable)

Parent/Guardian's Relationship to Student

Parent/Guardian's Cell Phone Number (If Applicable)

Parent/Guardian's Email Address (If Applicable)

Parent/Guardian's Street Address (if different from student)

City/State/Zip (if different from student)

EMERGENCY CONTACT

Name (Required Field)

Relationship (Required Field)

Phone Number (Required Field)

EMERGENCY MEDICAL ATTENTION

If the staff of Emmanuel Lutheran Church are not able to reach you if the need for emergency medical attention for your child should arise, then the staff will seek out the local emergency authorities to provide medical assistance

MEDICAL INFORMATION

Known Allergies/Special Needs:

Medications:

STUDENT PHOTO RELEASE FORM

I hereby grant to Emmanuel Lutheran Church in Norwood, Massachusetts the unqualified authorization to use and display photographs of the child listed on this form participating in church sponsored events on the:

Emmanuel Lutheran Church Website: (Required Field)
---YesNo

Emmanuel Lutheran Church Facebook Page: (Required Field)
---YesNo

Parent/Guardian's Name Who is Giving Photo Permission (Typing in your name will serve as your signature) (Required Field)

Parent/Guardian's Email (Required Field)

Date Signed (Required Field)

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