Summer Program - Registration Form 

JUNE 24 - 27, 2019

Child's Name

Date of Birth

Age/Grade in Fall Click Drop Down --> 4 Year Old Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade

Allergies/Limitations

Parent(s) Name

Street Address

Town

Home Phone

Parent's Cell Phone

E-Mail Address

Emergency Contact Name

Emergency Contact Phone

Comments

Acknowledge Terms and Conditions

  By checking this box, both legal parents/guardians of the child noted above are aware and agree that religious content will be discussed. I understand that pictures, videos and/or recordings may be taken of my child during Summer Faith Adventures activities to be used for

  church purposes only including the Church website, The Messenger, Social Media, picture disks, PowerPoint presentations, local newspaper & the Town Newsletter.

  I also understand the Sunday School Community Covenant will be discussed, which states “Children will support one another in efforts to be Responsible, Respectful, Prepared, Safe and Kind in all relations and interactions with others”.

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