St. Stephen's Church School Registration 2017-2018 Question Title * 1. Please begin by entering the contact information for the Parent(s)/Guardian(s): Name Email Cell Phone Home Phone Mailing Address Best way to reach you (Phone, Email, Facebook) OK Question Title * 2. Child #1 Name Age Birthday Grade (as of Fall 2017) Special Concerns (i.e. allergies, learning/developmental needs:) OK Question Title * 3. Child #2 Name Age Birthday Grade (as of Fall 2017) Special Concerns/Considerations (i.e. allergies, learning/developmental needs:) OK Question Title * 4. Child #3 Name Age Birthday Grade (as of Fall 2017) Special Concerns/Considerations (i.e. allergies, learning/developmental needs:) OK Question Title * 5. Child #4 Name Age Birthday Grade (as of Fall 2017) Special Concerns/Considerations (i.e. allergies, learning/developmental needs:) OK Question Title * 6. I would like to help out in the following areas (we request that all parents/guardians volunteer in some area at least once per season.)Select all that apply: Nursery (birth-24 months) 2 - 4 year old (Preschool) K & 1st Grade 2nd - 3rd Grade 4th - 5th Grade Story Teller Breakfast Helper 6th-8th Grade School and Service Projects OK Question Title * 7. Please review and initial the below emergency medical consent agreement.I (we) hereby authorize the teachers / staff of St. Stephen's Church School to act on my (our) behalf if emergency treatment is needed for my (our) child.If you agree, please type "Agree" followed by your initials. If not, please type "Do Not Agree." OK Question Title * 8. Please review and initial the below photography / film consent statement:I (we) give permission for St. Stephen's Episcopal Church to use any photograph or film of my child(ren) registered including, but not limited to, Advertising, promotion, public relations and news releases (including our website.)If you agree, please type "Agree" followed by your initials. If not, please type "Do Not Agree." OK SUBMIT REGISTRATION