Sunday School Registration

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Email *

Registration Info

Child's Name *

Child's Birth Date *

YYYY

Allergies or Medical Alerts

Parent Name(s) *

Address *

Primary Phone *

Persons authorized to pick up from class

Media Consent and Release

I hereby grant permission for St. Augustine Episcopal Church to record sounds, images, or video of my child named above during activities and events sponsored by St. Augustine Episcopal Church.
I also give permission for St Augustine Episcopal Church and/or The Episcopal Diocese of Northern California, of which it is a member congregation, to use these images in church and/or diocesan publications, marketing and promotional material, and on respective websites and social media sites.
Images used in the above mentioned means of communication will NOT include my child's address or phone number.

Media Consent and Release *

I AM AUTHORIZING use of my child's name in captions as they relate to church and/or diocesan communication listed above. Only the first name will be used with any image posted on church or diocesan social media sites.

I AM NOT AUTHORIZING use of my child's name in captions as they relate to church and/or diocesan communication listed above.

Signature. Please type name below to signify that the information provided is true and accurate, and that you have read and understand the terms of this agreement. *

Send me a copy of my responses.

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