United Methodist Church of Geneva Sunday School Registration Form 2019-20
BIRTH THROUGH 12TH GRADE - If you do not click SUBMIT at the bottom, your information will not be saved.
Family Information
Parent 1
*
First Name
Last Name
Cell Phone
-
Area Code
Phone Number
Parent 2
First Name
Last Name
Cell Phone
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone
-
Area Code
Phone Number
Preferred Email Contact
*
example@example.com
May Children receive email at this address?
Yes
No
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone
-
Area Code
Phone Number
Does your 3rd/4th Grader have permission to be released by themselves after Sunday School rather than waiting to be signed out?
*
Yes
No
Does not apply
Does your middle school/senior high student have permission to meet off-site with staff members and volunteers one-on-one in appropriate public settings (e.g.Starbucks, Panera, etc)?
*
Yes
No
Does not apply
List people other than parents who should be allowed to pick up your children
I consent to the use of any video or photographs taken of my child to be used without his/her name by the United Methodist Church of Geneva in promotional materials including newspapers, bulletin boards, newsletters and internet web pages.
*
Yes
No
I authorize adult volunteers and staff of the United Methodist Church of Geneva to consent to emergency medical or dental treatment and hospital care provided by a licensed practitioner. I agree to be liable for all related cost incurred for care.
*
Yes
No
I am interested in discussing volunteer opportunities in children's/youth ministry.
*
Preschool
Elementary
Middle School
High School
Substitute Only
Not at this time
Children's Information
Child 1 Name
*
First Name
Last Name
Child 1 Gender
*
Child 1 Birthdate
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Child 1 Grade Level
*
Nursery
3 year old
4 year old
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Child 1 Email (if different from Parent email)
example@example.com
Child 1 Allergies, Special Needs and Medical Information
Child 2 Name
First Name
Last Name
Child 2 Gender
Child 2 Birthdate
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Child 2 Grade Level
Nursery
3 year old
4 year old
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Child 2 Email (if different from Parent email)
example@example.com
Child 2 Allergies, Special Needs and Medical Information
Child 3 Name
First Name
Last Name
Child 3 Gender
Child 3 Birthdate
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Child 3 Grade Level
Nursery
3 year old
4 year old
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Child 3 Email (if different from Parent email)
example@example.com
Child 3 Allergies, Special Needs and Medical Information
Submit
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