725 Pine St.    Winnetka, Illinois 60093    847-441-3400

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Church School Registration  Church School Registration (Nursery through 6th grade only) Updated registration is required every year  Parent(s)’ Full Name(s) Address Phone E-mail Address**   ** important for church school and special events communication 1st Child’s Full Name Birth date  Nickname Mark Grade in Fall 2011 Nursery  Pre-K  K   1st  2nd  3rd  4th  5th 6nd Any allergies or medical condition we should be aware of?  No   Yes Pls.   2nd Child’s Full Name Birth date Nickname Mark Grade in Fall 2011 Nursery   Pre-K  K   1st  2nd  3rd  4th  5th 6nd Any allergies or medical condition we should be aware of?  No   Yes Pls.   3rd Child’s Full Name Birth date Nickname Mark Grade in Fall 2011 Nursery    Pre-K   K   1st 2nd  3rd  4th 5th  6nd Any allergies or medical condition we should be aware of?  No   Yes Pls. 4th Child’s Full Name Birth date Nickname Mark Grade in Fall 2011 Nursery    Pre-K  K   1st  2nd  3rd 4th  5th  6nd Any allergies or medical condition we should be aware of?  No   Yes Pls.   Please note here if you are comfortable with your child’s picture being taken and possibly used in church materials (if you do not indicate we will assume it is ok).   Yes, you may use my son/daughter’s picture in church materials No, you may not use my son/daughter’s picture in church materials Information provided will be treated confidentially.     To the top