St. John's Nursery Care, Sunday School, & Youth Group Registration 2025-2026

Please fill out this form and click submit.

Child 1:

First and Last Name

Nickname

Birthdate

Grade in September

Please select one option.

Under 3 PK3 PK4 Kindergarten 1 2 3 4 5 6 7 8 9 10 11 12

Baptized

Please select one option.

Yes No

For Confirmation Candidates: Baptism Date

For Youth Group: Teen's Mobile Phone

For Youth Group: Teen's Email (non school)

Child 2:

First and Last Name

Nickname

Birthdate

Grade in September

Please select one option.

Under 3 PK3 PK4 Kindergarten 1 2 3 4 5 6 7 8 9 10 11 12

Baptized

Please select one option.

Yes No

For Confirmation Candidates: Baptism Date

For Youth Group: Teen's Mobile Phone

For Youth Group: Teen's Email (non school)

Child 3:

First and Last Name

Nickname

Birthdate

Grade in September

Please select one option.

Under 3 PK3 PK4 Kindergarten 1 2 3 4 5 6 7 8 9 10 11 12

Baptized

Please select one option.

Yes No

For Confirmation Candidates: Baptism Date

For Youth Group: Teen's Mobile Phone

For Youth Group: Teen's Email (non school)

Music

Are you interested in learning about the Children's Choir (ages 3 - 10)?

Please select one option.

Yes please Not at this time

Does your child play an instrument? Are you interested in learning about your child playing at St. John's events?

Please select one option.

Yes please Not at this time

If yes, what musical instrument(s) does your child(ren) play?

Parent / Guardian 1:

First and Last Name

Mobile Phone

This address will receive a confirmation email

Home Phone

Mailing Address

Parent / Guardian 2:

First and Last Name

Mobile Phone

Home Phone

Mailing Address

Waivers

Are there any legal custody restrictions we should be aware of?

Please select one option.

Yes No

Please advise us of any accommodations, learning disabilities, food allergies, EpiPen, Inhaler, or other conditions or issues to be aware of.

Photo and Publishing Permission: I agree to allow St. John's Memorial Episcopal to use individual or group photographs of my child(ren) for related news articles, publications, website, social media, and/or advertisements.

Please select one option.

Yes No

Description

Please fill out this form and click submit.

St. John's Nursery Care, Sunday School, & Youth Group Registration 2025-2026

Description

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