Children's Sunday School Registration

Time Your Child Will Attend:

Saturday - 5:30 PM
Sunday - 9:30 AM
Sunday - 11:00 AM
Sunday - 6:30 PM

Child's Name:

Age:    Gender:    Male        Female

Date of Birth:  Month Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006  

School Grade 2008-2009 Preschool Kindergarten 1st 2nd 3rd 4th 5th

Street Address

City State Zip

Subdivision

Parent's Name(s)     

Is your child's last name different from yours?
No
Yes (If yes, please be sure to include last names in "Child's Name" and "Parent's Name" box)

Parent's Email Address

Home Phone Cell Phone

Emergency Contact (Non-Parent)
Name Phone

Allergies or medical concerns of which we should be aware?
Please type "none" if not applicable.

Are there any custody concerns we should be aware of? 
No      Yes, Please give us instructions:

How do you feel your child learns best?
Tell us something about your child:

We are always looking for those interested in serving in our Sunday School program.  If you are interested, please select the appropriate box(es) below:
I'm interested in serving in a class.
I'm interested in serving behind the scenes.

We periodically send out email to keep the parents informed on happenings in EUMC's Children's Ministries.  If you would NOT like to receive these emails, please check the box below.
Please do not include me in the monthly Children's Ministries Update email.

By submitting this form, you give Ebenezer UMC permission to use your child's likeness in internal publications (i.e. slide shows, videos, brochures), newsletters, and at ebenezerumc.org.  Ebenezer UMC believes in protecting the safety of your child, so names will never be published with pictures without obtaining separate permission from the parents or legal guardians.