Salem Alliance Church

PRESCHOOL UPDATE AND KINDERGARTEN REGISTRATION FORM

Child Information

Child's First Name:        Last Name:  

     Child's Gender: MaleFemale       Child's Date of Birth:   

          Address:   City:

              State:       Zip:    

              Home Phone:     

                 Mother's Cell Phone :   

                 Father's Cell Phone :

         Parent's Email Address:

         Parent(s)/Care Provider's Names:  

         Child's School:    

Attendance Information  

Child attends church with:     

Relationship to child: 

I attend worship services at:  5:006:309:3011:00

I attend a Community Group at: 5:006:309:3011:00
Do Not Attend a Community Group

Name of Community Group:  

Safety Information 

Please list any allergies or medical concerns that we need to know:

Please list any custody or safety information that we need to know:

 If there is important information about your child that will need to be communicated to the volunteers in his or her classroom, please complete our CLASSROOM CARE PLAN and return to your child's area pastor. Lori Christy - Birth to 2's, Wendy Allan - 3's and 4's, Christina Zeeb - Kindergarten.

Photo Release

  I grant permission for Salem Alliance Church to take pictures of my child to be used
          (without names) in newsletters, brochures, on our website, or within our church building.

  I do not want pictures of my child to be used in newsletters, brochures, on our website,
          or within our church building.

Volunteer Opportunities

 We are interested in volunteering in my child's classroom:    

                On a regular basis      On occasion      

 We are interested in volunteering in another area of children's ministries.

                  My area(s) of interest are: