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Sunday School Registration - Delavan UCC
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* Indicates required question
Name:
*
Your answer
Birth Date:
*
MM
/
DD
/
YYYY
Age:
*
Your answer
Grade in School This Year (2019-2020):
*
Your answer
Allergies, Medical Information, or Other Concerns:
Your answer
Address:
*
Your answer
Phone Number (Home):
Your answer
Phone Number (Cell):
Your answer
Phone Number (Other):
Your answer
Email Address:
Your answer
Parent(s)/Guardian(s) Name(s):
Your answer
Emergency Contact - Primary (Name & Phone Number):
*
Your answer
Emergency Contact - Secondary (Name & Phone Number):
*
Your answer
Do you give consent for pictures or images of your child taken during class or church programs/events to be shared on our social media and promotional materials?
*
Yes
No
Other:
Do you give consent for your child to go on walking field trips?
*
Yes
No
Is there anything that would be helpful for our teachers to know in order for your child to feel comfortable and welcome in our learning environment?
Your answer
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