Church School Registration Form

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Children's Names

Parent / Guardian 1

Name

Address

Phone

Okay to text?

yes

Parent / Guardian 2

Name

Address

Phone

Please check the programs and activities in which you would be willing to assist:

Nursery

Church School

Youth Group

Special Programming

Youth Choir

Please check below if you authorize:

I give permission to have photographs of my child(ren) posted on the church website, Facebook page, and/or newsletters.

**In case of Emergency, or if I cannot be reached to pick up my child(ren), I hereby authorize the following person(s) to pick up by child(ren):

Contact #1

Phone number

Relationship to Child(ren)

Contact #2

Phone number

Relationship to Child(ren)

Parent / Guardian Signature

Date

Child 1

Last name

First Name

Birthday

Age

Grade

Allergies and Medical Conditions

Current School

Activities and Interests

Please check the programs and activities in which this child will participate:

Nursery (ages 0–2)

Church School (age 3 to grade 5th)

CLUB 345 (grades 3rd–5th)

Confirmation Class (grades 7th–12th)

Acolyte (grades 3rd–12th)

Youth Group (grades 6th–12th)

Youth Choir

Child 2

Last name

First Name

Birthday

Age

Grade

Allergies and Medical Conditions

Current School

Activities and Interests

Please check the programs and activities in which this child will participate:

Nursery (ages 0–2)

Church School (age 3 to grade 5th)

CLUB 345 (grades 3rd–5th)

Confirmation Class (grades 7th–12th)

Acolyte (grades 3rd–12th)

Youth Group (grades 6th–12th)

Youth Choir

Child 3

Last name

First Name

Birthday

Age

Grade

Allergies and Medical Conditions

Current School

Activities and Interests

Please check the programs and activities in which this child will participate:

Nursery (ages 0–2)

Church School (age 3 to grade 5th)

CLUB 345 (grades 3rd–5th)

Confirmation Class (grades 7th–12th)

Acolyte (grades 3rd–12th)

Youth Group (grades 6th–12th)

Youth Choir

Thanks for submitting!

Phone: 860-739-2324

Address:

St. John's Episcopal Church
400 Main Street
P. O. Box 810
Niantic, CT 06357

Office hours:

Monday through Friday 8:45am–12:45pm

Voicemail is checked daily, so leave us a message and we will return your call.

Email:
Office: admin@stjohnsniantic.org

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