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Fall 2009-Spring 2010 STUDENT REGISTRATION FORM
Trinity United Methodist Church, 4150 S. Shade Ave., Sarasota Phone # 924-7756
Sherrill Carr, Director of Christian Education sherrill@iTrinity.org
Please fill out one form for EACH CHILD OR YOUTH. Return to welcome booth or church office ASAP.
YOUTH’S NAME _________________________
Female _____ Male ______
BIRTH DATE ___/____/____ Child’s/Youth’s Age as of Sept. 1st, 2009 ____
ADDRESS __________________________________________ ZIP_________
School Status Fall 2009 (Circle One):
Infant/Toddler (0 - 2 yrs) Preschool (3-4 yrs)
Grade: K 1 2 3 4 5 6 7 8 9 10 11 12
PARENTS’ NAMES: ___________________________________________________________
PHONE #s: home:_________________ work: _________________
cell: __________________ cell: __________________
E-MAIL ADDRESS: ________________________________________________
In case of an emergency, who should we contact? ___________________________
Emergency contact phone #(s): __________________________________________
Does your child have any allergies or special needs? If so, please describe.
_______________________________________________________________________________
_______________________________________________________________________________
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