1st Reformed Church of Scotia Sunday-School Registration

Name: Click here to enter text.

Birthdate: Click here to enter text.	Age: Click here to enter text.	Grade: Click here to enter text.

Baptism date (if applicable): Click here to enter text.

Parent’s/Guardian’s Name: Click here to enter text.

Address: Click here to enter text.

Phone: Click here to enter text.

Email: Click here to enter text.

Parent’s/Guardian’s Name: Click here to enter text.

Address (if different): Click here to enter text.

Phone (if different): Click here to enter text.

Email: Click here to enter text.

Child’s special interests and activities: Click here to enter text.

Any Allergies?: Click here to enter text.

Siblings attending Sunday school?

Names/Ages: Click here to enter text.

Emergency contact during Sunday school time:

☐ I will probably be in the church building

Other: Click here to enter text.

Please list names (and relationship to child) of who can pick up child from Sunday School or Nursery.

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Willing to help in the following area (not mandatory!)

☐ Driving for youth group events ☐Prayer Support ☐Donate supplies ☐Leading a workshop

☐ Food for special occasions ☐Extra set of hands for projects

Additional information / special instructions / suggestions: Click here to enter text.