Child's Full Name:

Name Child Prefers to Use:

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

Name of School, if attenting kindergarten:

Has your child been baptized: Yes No

If yes, Date of Baptism:

Place of Baptism:

Parents or Guardians' 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 check the areas in which you can help. Thanks for your consideration in being part of this ministry!

Volunteer Opportunities Please check the areas in which you can help. Thanks for your consideration in being part of this ministry:
	Providing supplies for the Feast (e.g., juice, cookies, fruit)
	Constructing story supplies (e.g. woodworking, banner making)
	Substitute Greeter

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.