Student Information Child 1 * First Name Last Name Birthday * MM DD YYYY Age or Grade in September 2021 * (*Grades 6-12 are considered Youth Group) Preschool Pre-K Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade Allergies / Medical Concerns Child 2 First Name Last Name Birthday MM DD YYYY Age or Grade in September 2021 (*Grades 6-12 are considered Youth Group) Preschool Pre-K Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade Allergies / Medical Concerns Child 3 First Name Last Name Birthday MM DD YYYY Age or Grade in September 2021 (*Grades 6-12 are considered Youth Group) Preschool Pre-K Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade Allergies / Medical Concerns Parent / Guardian 1 * First Name Last Name Email * Add to the Children's Ministry email distribution list? * Yes! No thanks Phone * (###) ### #### Parent / Guardian 2 First Name Last Name Email Add to the Children's Ministry email distribution list? Yes! No thanks Phone (###) ### #### Thank you!
