Please use your tab key, not your enter key!!!

Child’s name   

Parent/Guardian Name

Address

Phone numbers:  Home Work Cell

Email:

 

Class Placement Information:

        Preschool & Kindergarten:  Please mark the appropriate class placement.  Children must be three years old by January 1, 2008

    Must provide birth date:

        Classes are divided as follows      

Three year olds

       Four year olds          

                                                                                                                                       Five year olds  

                                          For five year olds please indicate whether just completed or just going into Kindergarten

 

        Grades 1 – 6:  Please mark the appropriate class placement for your child below. Criteria for placement is grade just completed, i.e. just completed 2^nd grade, placement is 1^st & 2^nd grade, just completed 4^th grade, placement is 3^rd & 4^th grade, just completed 6^th grade, placement is 5^th & 6^th grade.  Please indicate grade just completed in the space provided.

                        First & Second Grade           Grade just completed

                                                                       

                        Third & Fourth Grade           Grade just completed

 

                        Fifth & Sixth Grade               Grade just completed

 

Medical Information:  Medical or other information we need to know. (Please include food allergies.)

 

Emergency Contact:

Name: Phone number:

Name: Phone number:

 

Dismissal Information:

Who may pick up your child at the end of each VBS day?

 

Other Information: 

Do you attend Sunday School?   If so, where?