7th - 12th Grade Reg Form - MONTEZUMA UNITED METHODIST CHURCH

Student's Information

* Indicates required field

Name *

First

Last

Address *

City *

State *

Zip Code *

Student's Email (If they have one) *

Parent / Guardian Information

Parent / Guardian 1 - Name *

First

Last

Parent / Guardian 2 Name *

First

Last

Parent / Guardian 1 Parent's Email *

Parent / Guardian 2 Email *

Parent / Guardian 1 Phone Number *

Parent / Guardian 2 Phone Number *

Other Siblings

Name-Sibling 1 *

First

Last

Name-Sibling 2 *

First

Last

Name Sibling 3 *

First

Last

Name-Sibling 4 *

First

Last

Emergency Contact Information

Emergency Contact *

First

Last

Emergency Contact Phone Number *

Medical Information

Allergies *

What Else Do We Need To Know About Your Child? *

Image Use Agreement

I give permission to Montezuma United Methodist Church to use images of the child listed above for Montezuma United Methodist Church's website, Facebook page or any other way Montezuma United Methodist Church deems appropriate.

Image Use *

Yes No

Submit

Sunday School Register Form
7th thru 12th Grade

Student's Information

Other Siblings

Medical Information

Image Use Agreement

We Would Love to Have You Visit Soon!

Hours

Telephone

Address

Sunday School Register Form7th thru 12th Grade

Student's Information

Other Siblings

Medical Information

Image Use Agreement

We Would Love to Have You Visit Soon!

Hours

Telephone

Address

Sunday School Register Form
7th thru 12th Grade