BIBLE-IN-A-BOX REGISTRATION
2008-2009
 

Sunday Morning Program for
Pre-School Children, Age 2 - 3

Please complete a separate registration for each child.

Child's Full Name:

Name Child Prefers to Use:

Female Male Date of Birth:  
    Attending Preschool?: Yes No

Name of School, if attending preschool:

Has your child been baptized: Yes No

If yes, Date of Baptism:

Place of Baptism:

Parents or Gardians' Names:

Street Address:

City, State, Zip:

Home Phone:

Work Phone:

Cell Phone:

Fax:

Email:

Person to contact in emergency if parents/guardians not available. Please provide name, address and phone:

Comments or special information regarding activity, medical or diet restrictions:

Where will you be during the Sunday Education hour?

Volunteer Opportunities: Please let us know where you can help:

 

You will be asked to sign the following medical release before leaving your child in Church School:

EMERGENCY MEDICAL RELEASE: In case of a medical emergency, I give my permission for emergency medical care to be administered to my child until I can be reached for expressed permission.