Youth Sunday School Registration - Church of the Holy Comforter

Child's Name:*

First Last

Child's Nickname (if Applicable):

Parent or Guardian Name:*

First Last

Parent or Guardian Name:

First Last

Child's Date of Birth:*

Grade in school:

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*

Email*

Preferred Method of Communication:

Call
Text
Email

Please list any allergies or other conditions we should be aware of (food reactions, physical challenges, ADD/ADHD, etc.):

Emergency Contact Name:*

First Last

Phone # for Emergency Contact:*

Comments:

Because we love taking pictures at Holy Comforter, we need your permission to photograph your child. I grant to the Church of the Holy Comforter and the Episcopal Diocese of MD, its representatives and employees, the right to take photographs of my child and my property. I authorize CHC and the Diocese, its assignees and transferees the right to copyright, use and publish the same in print and/or electronically. I agree that such photographs of my child may be used with or without their first name and for any lawful purpose, including such purposes as publicity, illustration, advertising, Web content, etc. I have read and understand the above.*

Yes- I agree
No- I do not agree

Signature of Parent or Guardian*

Date*

Youth Sunday School Registration Form