Sunday School Registration

Please submit one form for each child you wish to register.

Child's Name(*)

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Child goes by(*)

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Enter the name your child prefers to be known by.

Gender(*)

MaleFemale Please Select Male or Female

Birth Date(*)

Select

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School

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Rising Grade(*)

Pre-KK123456789101112 Invalid Input

What grade will the child be entering in the Fall of the school year?

Parent's Name(s)(*)

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Address Line 1(*)

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Address Line 2

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City(*)

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State(*)

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ZIP Code(*)

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Home Phone(*)

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Cell Phone(*)

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email address(*)

Please enter a valid email address.

Pictures

By checking this box I agree that pictures of my child in Sunday School may be used for the church website and publications. No names will be associated with pictures. Invalid Input

Certification(*)

By checking this box I am certifying that the information on this form is correct and that I am legally responsible for the child listed here. Invalid Input

Please list any physical or medical conditions (including allergies) or special needs that the teacher should be aware of:

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What are your child’s strengths?

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What are your child’s challenges (learning, attention, behavior etc.)?

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St. Peter’s relies on parent volunteers in the Children’s Ministries.

Would you be willing to act as a classroom aide periodically?(*)

YesNo Invalid Input

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St. Peter's Episcopal Church | The Rev. Dr. Tom Simmons, Rector | 37018 Glendale Street, Purcellville, Virginia | Ph 540.338.7307