Student Name *

First Name

Last Name

Parent/Guardian Name *

First Name

Last Name

Parent/Guardian Name

First Name

Last Name

Phone *

(###)

###

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Does your child have any allergies, special needs, dietary restrictions that we should know about? *

Yes

No

Emergency # to contact during Sunday School:

(###)

###

####

Is it ok for pictures of your child to be used in places such as Trinity’s facebook page, website, or newsletter? *

Yes

No