AMUMC Student Information Form

Please fill out this form and click submit.

Child's Name

*

Birthdate

*

Grade

*

Parents/Guardian First & Last Name

*

Address

*

Phone

*

Email

*

This address will receive a confirmation email

Other church school family members (Name/Relationship/Age)

*

Emergency Contact Name

*

Emergency Contact Phone Number

*

Allergies or other medical condition leaders/shepards should know about your child

*

I am happy to help with (please check)

Please select one option.

Workshop Leader substitute: storytelling/music Workshop Leader substitute: video Workshop Leader substitute: cooking Workshop Leader substitute: science Workshop Leader substitute: art Workshop Leader substitute: games

I can help with (please check)

Please select one option.

Pre-K substitute 7th & 8th grade substitute Shepherd Nursery/Toddler Room

Please check below if you want to give AMUMC permission to publish pictures of your child participating in church activities

*

Please select all that apply.

in the newsletter in printed announcements on the church website on church social media I DO NOT GIVE PERMISSION

Parent/Guardian Signature

*

Description

Please fill out this form and click submit.

Please Fix the Following

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