To register: Print, fill out, then then mail this form to: Gail Hughson, Director of Children’s Ministries Trinitarian Congregational Church 53 Cochituate Road Wayland, MA 01778
Name: _____________________________
Age: _______ DOB: ________________
Grade: ___ School: _______________
Street: _____________________________
City:_______________ Zip: ___________
Area & Tele # ______________________
Mother’s Name:_____________________
Father’s Name: _____________________
Email: _____________________________
May we email your child with current activities and Bible challenges? Yes___ No___
Adult responsible for child if different than above: ________________________
Needs we need to be Aware of:
Learning:___________________________
Medical: ___________________________
Allergies (food): ____________________
Would you be willing to assist with our child’s class if occasionally needed?
Yes___ No___
You have my permission to use photos of my child, taken during church programs,for the TCC website or for promotional material (i.e. local newspaper, church publications).
Yes___ No___
Parent/Guardian signature: X______________________________________
