Name             
                                                                                                                                                                   Grade
Address



Birthday  Month                      Day                 Year


E-mail:

  Mother's Name(or legal guardian)                                                                           Cell


  Father's Name(or legal guardian)                                                                        Cell


     Alternate Pickup: 






     
Emergency Contact:





     
      
Allergies, Medical Needs or Special needs (please be detailed)







 
         
    
Singing Parts







Shirt Size


   

  May we have permission to photograph your child and use your child's photograph in any and all forms of New Covenant  
  Christian Church publications (i.e. Church websites, brochures, newsletter etc.)

 
 








 
yes
no
Speaking Part