REGISTRATION 2007
REGISTRATION 2007
FAMILY INFORMATION
Last Name ________________________________________________________________
Address __________________________________________________________________
_________________________________________________________________
Home Phone ______________________ Email __________________________________
Mother's Name _____________________ Cell Phone ______________________________
Father's Name _____________________ Cell Phone ______________________________
CHILD INFORMATION
Child’s Name _____________________________
Date of Birth ____________________Grade _____
School __________________________________
Allergies/Special Needs No ____ Yes ____ If Yes, please describe:
_______________________________________
_______________________________________ _______________________________________
Email __________________________________
|
Child’s Name _____________________________
Date of Birth ____________________Grade _____
School __________________________________
Allergies/Special Needs No ____ Yes ____ If Yes, please describe:
_______________________________________
_______________________________________ _______________________________________
Email __________________________________ |
Volunteer interest: Classroom Assistant___ Arts & Crafts___ Jr. Choir___ Nursery___ Service Projects___ Events___
Parent signature ____________________________________________ Date ___________________