Religious Education Registration for Children and Youth

Please fill out this form and click submit.

Parent/Guardian/Caregiver

Name

*

Email

*

This address will receive a confirmation email

Address

*

Cell Phone

*

Home Phone

How many children will participate in the RE program?

*

Please select one option.

1 2 3 4 5 or more

Additional Parent/Guardian/Caregiver

First Name

Last Name

Email

This address will receive a confirmation email

Address

Cell Phone

Home Phone

1st Child

Child's First Name

*

Child's Last Name

*

Child's Birthday

*

Child's Grade Level

*

Please select one option.

Not in School Pre-K 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade

Please list all known allergies, special needs, and anything else you would like the Director of Religious Education to know about your child.

*

2nd Child

Child's First Name

Child's Last Name

Child's Birthday

Child's Grade Level

Please select one option.

Not in school Pre-K 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade

Please list all known allergies, special needs, and anything else you would like the Director of Religious Education to know about your child.

3rd Child

Child's First Name

Child's Last Name

Child's Birthday

Child's Grade level

Please select one option.

Not in School Pre-K 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade

Please list all known allergies, special needs, and anything else you would like the Director of Religious Education to know about your child.

4th Child

Child's First Name

Child's Last Name

Child's Birthday

Child's Grade Level

Please select one option.

No in School Pre-K 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade

Please list all known allergies, special needs, and anything else you would like the Director of Religious Education to know about your child.

5th Child

Child's First Name

Child's Last Name

Child's Birthday

Child's Grade Level

Please select one option.

Not in School Pre-K 1st Grade 2nd Grade 3rd Grade 4h Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade

Please list all known allergies, special needs, and anything else you would like the Director of Religious Education to know about your child.

If you have more than 5 children please talk to the DRE about getting them registered.

Child Pick-up

All children must be signed out from the Nursery or Religious Education classroom by one of the parents/guardians listed above.

In the event of an emergency, Religious Education/Child Care staff and volunteers will apply first aid and/or seek medical attention for the child. Parents are asked to keep their phones available (on vibrate during the worship service) in case we need to contact you.

Please use this space to leave questions/comments about emergency procedures.

Description

Please fill out this form and click submit.

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