Sunday School Registration

Name*

First Last

Birthdate

Grade

Address

Street Address City State / Province / Region ZIP / Postal Code

Cell Number

Email*

School

Parents’ Name

First Last

Parents’ Work Phone

Siblings (age/grade)

Baptized?

Yes
No

If baptized, when and where?

Additional Information

*From time to time we take pictures of children in Sunday School, Church, or parish events. By signing below, you agree to allow The Church of the Good Samaritan to, on occasion, publish photos of your child(ren) on our website, or in our newsletters, or on Social Media. Names are not identified with the photos. Good Samaritan cares about the safety of your children!

Special Notes for teachers (allergies, special needs, talents, etc.)