Sunday School Online Registration

Student's Name

First Name

Last Name

Date of Birth

YYYY

Grade Entering

Food Allergies

Student #2

Name

Student #2 Date of Birth

YYYY

Student # 2 Grade Entering

Student #2 Food Allergies

Student # 3

Name

Student #3 Date of Birth

YYYY

Student # 3 Grade Entering

Student # 3 Food Allergies

Student # 4

Name

Student #4 Date of Birth

YYYY

Student #4 Grade Entering

Student # 4 Food Allergies

Relatives or Friends with permission to pick up your child(ren)

Emergency Contact Information

In the event we are unable to contact you during an emergency, please provide the name and number of an emergency contact. Please also add any addition information you would like to know.

Photo Release

Unless indicated here, we will assume we have permission to take pictures and or videos of your child(ren). These images and recordings may appear on Facebook, Instagram, in our weekly email communication or monthly newsletter.

I grant permission to use photos and videos

I do not grant permission for use of photos and videos

Parent/Guardian Names

Phone

Please list best number to reach you at.

(###)

###

####

Address

City, State, Zip

Sunday School Online Registration

Sundays @ 10

W5706 State Road 72
Ellsworth, WI 54011
(715) 273-3118

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