Christian Education




 Salem United Church of Christ
2017-18 Sunday School Registration 


Student Name: _____________________________________________________

Date of Birth: __________ Current Age: __________ Grade for 2016-17: _______

Student Name: ______________________________________________________

Date of Birth: __________ Current Age: __________ Grade for 2016-17: ________

Student Name: _____________________________________________________ 

Date of Birth: __________ Current Age: __________ Grade for 2016-17: _______ 

Student Name: ____________________________________________________ 

Date of Birth: __________ Current Age: __________ Grade for 2016-17: _______

Parent Name: _______________________________________________________

Address: ___________________________________________________________ 

Home Phone: ______________________ Cell Phone: _______________________

Email Address: _____________________________________________________

Parent Name: ______________________________________________________

Address (if different than above): _______________________________________

Home Phone: ______________________ Cell Phone: ______________________

Email Address: _____________________________________________________


Others authorized for drop-off and pick-up 

Name(s): _____________________________________________________________ 

Relationship to Child: ____________________________________________________ 

Home Phone: ______________________ Cell Phone: __________________________






Page 2 of

Salem United Church Christ
2017-18 Sunday School Registration

Please share any information such as allergies, medical concerns or special physical or educational needs you think will help us better meet your child's needs.

_____________________________________________________________________

_____________________________________________________________________

______________________________________________________________________


Photos of your child(ren) participating in Christian Education activities will be posted on www.salemchurchverona.org with your permission only 

___ I grant Salem UCC permission to post my child(ren) on the church website


___ Please do not post photos of my child(ren) on the church website             




Signature: _______________________________________ Date: ________________ 




Please return completed form to the Sunday School Superintendant mailbox in the church office. Thank you. 


**To print this out , press control or command P, any problem contact webmaster@salemchurchverona.com.