Thursday School Registration Form


Child's Name: Preferred to be called:
Date of Birth: Current Age: Gender:
Other Children ( name & age ):
Street: City: State: Zip:
Father's Name: Home Phone: Cell Phone: Work Phone:
Mother's Name: Home Phone: Cell Phone: Work Phone:
Email Address: Church Affiliation:
List Child Allergies:

Emergency Record

    Our Staff of willing and capable teachers will do all that is possible to make your little child happy, secure, and safe. However, please fill out this portion as a precautionary measure.

I authorize the Thursday School Staff to contact the following if I cannot be reached in case of an emergency, illness, or accident:

I will not hold Goodman Oaks Church, Thursday School, or any staff member thereof responsible for illness or accidents incurred while my child is in their care.

Emergency Contacts
1st Contact Name: Relationship: Home #: Cell #: Work #:
2nd Contact Name: Relationship: Home #: Cell #: Work #: