The Sphere at NAPC Elementary Ministry Registration 2019-2020

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Please register your child for the Great North Elementary Department at North Avenue Presbyterian Church by completing this form. When you have submitted the form, a confirmation should appear at the top of the form. Thank you!

Child's Last Name *

Child's First Name *

Name Child Goes By (if different from first name)

Child's Birth-date *month/day/year *

YYYY

Child's Gender *

Male

Female

Child's Age as of September 1, 2019 *

Grade *

Kindergarten

First

Second

Third

Fourth

Fifth

Parent/Guardian Full Name *

Street Address *

City, State, Zip *

Phone Number *

Parent/Guardian E-mail Address (We will e-mail all further communication about North Avenue) *

Does your child have any allergies or conditions that would affect their participation? *

Yes

Please list any allergies or conditions that would affect your child's participation.

Children's Choir *

Also register my child for Cherub Choir (Kindergarten)

Also register my child for Junior Choir (Grades 1-5)

Required

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Phone Number *

Please check the following boxes: *

I give permission for my son/daughter to participate in Sunday programs sponsored by North Avenue Presbyterian Church. In case of an emergency, the leaders have permission to have my child medically treated in whahtever manner needed.

I hereby release North Avenue Presbyterian Church and its representatives from any liability as a result of my child's participation.

My child's photo may be used on the North Avenue website and social media (Facebook, Instagram, Twitter) as we share Sunday program pictures.

My child's photo may be used in printed North Avenue material (no photo will be used in non-NAPC material)

Required

I will volunteer *

In the Preschool Department

In the Elementary Department

Elsewhere

Required

Signature (Please type your name as your signature.) *

Submit

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