Sunday School Registration Form Student 1 Information * First Name Last Name Student 1 Preferred Name * Student 1 Date of Birth * MM DD YYYY Student 1 Baptismal Name * Student 1 Name Day * MM DD YYYY Student 1 Grade * Grade K Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Student 1 Email (if applicable) Student 1 Cell Phone (if applicable) (###) ### #### Student 2 Information First Name Last Name Student 2 Preferred Name Student 2 Date of Birth MM DD YYYY Student 2 Baptismal Name Student 2 Name Day MM DD YYYY Student 2 Grade Grade K Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Student 2 Email (if applicable) Student 2 Cell Phone (if applicable) (###) ### #### Student 3 Information First Name Last Name Student 3 Preferred Name Student 3 Date of Birth MM DD YYYY Student 3 Baptismal Name Student 3 Name Day MM DD YYYY Student 3 Grade Grade K Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Student 3 Email (if applicable) Student 3 Cell Phone (if applicable) (###) ### #### Student 4 Information First Name Last Name Student 4 Preferred Name Student 4 Date of Birth MM DD YYYY Student 4 Baptismal Name Student 4 Name Day MM DD YYYY Student 4 Grade Grade K Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Student 4 Email (if applicable) Student 4 Cell Phone (if applicable) (###) ### #### Parent/Guardian 1 Information * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Parent/Guardian 1 Email * Parent/Guardian 1 Cell Phone * Country (###) ### #### Parent/Guardian 2 Information First Name Last Name Parent/Guardian 2 Email Parent/Guardian 2 Cell Phone Country (###) ### #### Media Consent and Release * I hereby give St. Andrew Greek Orthodox Church and its employees, representatives, and authorized media organizations permission to print, photograph, and record my child for use in audio, video, film, or any other electronic, digital and printed media. a. This is with the understanding that neither the St. Andrew Greek Orthodox Church nor its representatives will reproduce said photograph, interview, or likeness for any commercial value or receive monetary gain for use of any reproduction/broadcast of said photograph or likeness. I am also fully aware that I will not receive monetary compensation for my child’s participation. b. I further release and relieve the St. Andrew Greek Orthodox Church, its employees, and other representatives from any liabilities, known or unknown, arising out of the use of this material. I certify that I have read the Media Consent and Release Liability statement and fully understand its terms and conditions. Agree Disagree Signature * I understand that checking this box and providing my name below constitutes a legal signature and that by doing so I am agreeing to the terms and conditions set above. Further I acknowledge and affirm that I have read and understand all the above information. Thank you!
