Yearly Registration '21-'22 School Year
starts Sept. 12 | Please fill out one per child to register Sunday School.
Child Information
Child's Name
*
Grade
*
Please select one option.
No Grade
Pre-Kindergarten
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Graduated
Select Option
No Grade
Pre-Kindergarten
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Graduated
Age
*
Parent/Guardian Information
Parent/Guardian 1
*
Parent/Guardian 2
Email
*
This address will receive a confirmation email
Phone
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Emergency Information
Doctor's Name
*
Doctor's Phone
*
Emergency Contact's Name
*
Emergency Contact's Phone
*
Emergency Contact's Address
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Hospital Preference
*
Health Information
Please List any Special Medical Conditions:
Allergies
Last Tetnus Shot (DTaP for younger children):
*
Other
I consent to allow FPCSS to take and use pictures or videos of my child. These photos may be posted on the website as a recap of the event or for promotion of future VBS events. No names will be used.
Photos
*
Please select all that apply.
Photos
NO Photos
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Description
starts Sept. 12
Please fill out one per child to register Sunday School.
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