2023-2024 Student Church School Registration

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2023-2024 Student Church School RegistrationKathy Kenny2023-08-25T18:37:27+00:00

Date:

Student's Name: Last name, first name, nickname

Birthdate:

Grade:

Address:

Allergies/medical concerns:

Other concerns we should be aware of:

Primary Contact:

Parent
Other (relationship)

Name (Ms., Mr.)

Phone number:

Okay to text?

Yes
No

Address:

Email:

Second Contact:

Parent
Other (relationship)

Name (Ms., Mr.)

Phone number:

Okay to text?

Yes
No

Photo Release: Brick Presbyterian Church has my permission to use my child's photograph publicly in BPC materials. I understand the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee, or other compensation shall become payable to me by reason of such use.

I grant permission
I do not grant permission

Signature of Parent/Guardian

Date

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