AMUMC Student Information Form
Please fill out this form and click submit.
Child's Name
*
Birthdate
*
Grade
*
Parents/Guardian First & Last Name
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
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
I DO NOT GIVE PERMISSION
Parent/Guardian Signature
*
Submit
Description
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