Middlebury Congregational Church Sunday School Registration Form 2022-2023

Please fill out this form and click submit.

Parent/Guardian Name

Additional Parent/Guardian Name

This address will receive a confirmation email

Phone

Phone (2)

Address

Child Name (1)

Child 1 Birthdate

Child 1 Grade (2022-23 school year)

Please select one option.

Baby/Toddler PreK K 1 2 3 4 5 6 7

Child 2 Name

Child 2 Birthdate

Child 2 Grade (2022-23 school year)

Please select one option.

Baby/Toddler PreK K 1 2 3 4 5 6 7

Child 3 Name

Child 3 Birthdate

Child 3 Grade

Please select one option.

Baby/Toddler PreK K 1 2 3 4 5 6 7

Child 4 Name

Child 4 Birthdate

Child 4 Grade

Please select all that apply.

baby/toddler PreK K 1 2 3 4 5 6 7

Does your child(ren) have any allergies, medical conditions, dietary considerations, or special needs we should know about? If so, please describe and include any accommodations necessary.

Emergency Contact: Name, relationship, phone number

Alternate Person Responsible for pick-up

Permissions: Photos may taken and be used for: bulletin boards, publications (Church newsletters, newspaper), MCC website and/or Social Media.

Please select all that apply.

I acknowledge and agree

Due to the changes in the Covid-19 Pandemic, precautions such as masking may be necessary depending on community levels. All participants must follow all regulations, such as masking, if required.

Please select one option.

I acknowledge and agree

My child/children has permission to participate in the MCC Sunday School events between September 2022 and July 2023. I understand that I may not hold MCC liable in case of accident or injury to my child. I give permission for medical care to be given should my child need treatment before I am contacted.

Please select one option.

I acknowledge and agree

Description

Please fill out this form and click submit.

Middlebury Congregational Church Sunday School Registration Form 2022-2023

Description

Please Fix the Following