Contact Information

Parent(s) Name(s) *

Street Address *

City * State * Zip *

Phone(s) *

Please indicate whether phone number(s) are cell, home or work.

Email *

This family is new to Redeemer * YesNo

Child 1

Name

Date of Birth
MonthJanFebMarAprMayJunJulAugSepOctNovDec   Day12345678910111213141516171819202122232425262728293031   Year1996199719981999200020012002200320042005200620072008200920102011201220132014

Grade in School September 2015  

This child is new to Church School YesNo

Any health or allergy alerts

Child 2

Name

Date of Birth
MonthJanFebMarAprMayJunJulAugSepOctNovDec   Day12345678910111213141516171819202122232425262728293031   Year1999200020012002200320042005200620072008200920102011201220132014

Grade in School September 2015  

This child is new to Church School YesNo

Any health or allergy alerts

Child 3

Name

Date of Birth
MonthJanFebMarAprMayJunJulAugSepOctNovDec   Day12345678910111213141516171819202122232425262728293031   Year1999200020012002200320042005200620072008200920102011201220132014

Grade in School September 2015  

This child is new to Church School YesNo

Any health or allergy alerts

I can help Church School by...

Please check the ways you are willing to help the Church School
TeachSubstituteDrive on field trips* (this is for middle and high school students)Chaperone a trip (for middle and high school students) without drivingHelp plan an outreach activityHelp plan an educational activityHelp plan a fun activityHelp with seasonal activities (All Saints, Christmas, Epiphany, Easter or Pentecost)

*If willing to drive on field trips, please enter your car's:

License plate number  

Make and model  

Number of seat belts in addition to driver  

A note about photos and videos

At Redeemer, photos and/or videos are often taken at the Strawberry Festival, Christmas pageant, Blessing of the Animals, the Easter egg hunt, and other special events in which children participate. These photos and videos may be posted on Redeemer’s website or Facebook page, used in printed materials to illustrate our community for potential visitors. Children are never identified by name.

It is Redeemer’s policy to respect the wishes of parents regarding photos or videos that include their children. Please tell us below if there are any ways you do not wish for photos or videos including your children to be used publicly.