Child's Name Birthday Grade Mother's Name Father's Name Email Address Address City Zip Code Home Phone Work Phone   Child has been Baptized Yes No Child will be picked up by Parents? Yes No By Sibling Name of Sibling Note: Children in 3rd grade - 5th grade are allowed to sign themselves into Sunday School class and leave without a parent picking them up if the parents give their permission. My child may leave at the end of class without a parent. My child may NOT leave class without a parent picking them up. List and describe any allergies/medications/learning difficulties or physical limitations: I/We give permisson for St. Thomas Presbyterian Church to use my/our child's photo in promotions (publications or website) and publicity regarding various activities of St. Thomas Presbyterian Church waive the right to inspect or approve finished photographs or the use to which it may be put or the copy of connection therewith. By checking the above I/We indicate my/our consent with the above Publicity Release statement. Security code:   * Do not enter anything in this field: