Child's Name
Parent's/Guardian's Name
Address:
Telephone:
E-mail:
Age of Child:     Grade:     Birth date:

Please list any allergies/medical conditions that we need to know about (or indicate "None")


Is there someone other than the parent/guardian who is authorized to pick up your child from Sunday School?
Yes    No        If so, who?

If your child is under the age of 4, does he/she require assistance when going to the bathroom?          
Yes    No

Video/Photograph Permission:

Children involved in our ministry programs at Skyline are sometimes photographed or video taped for publicity and/or advertising within the Skyline congregation. These photographs and/or video may be shown on bulletin boards, shown during worship services, and/or appear on Skyline’s website. For safety, children will NOT be named.

Skyline UMC has my permission to photograph and/or video tape my child: Yes    No

Parent's Name         Date