AMUMC Student Information Form
School year 2023 - 2024
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Childs Name *
Birthdate *
MM
/
DD
/
YYYY
Grade *
Parents/Guardian Full name *
Home Address *
Home Phone/Cell Phone *
Email Address *
Other church school family members (Name/Relationship/Age) *
Emergency Contact Name & Phone Number *
Allergies or other medical condition leaders/shepards should know about your child *
I am happy to help with (please check)
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I can help with (please check)
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Please check below if you want to give AMUMC permission to publish pictures of your child participating in church activities *
Required
Parent/Guardian Signature
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