Sunday Preschool Registration

*Address Line 1
Address Line 2
*Zip/Postal Code
A separate form should be filled out for each child (age 2 years prior to September 1 through Pre-Kindergarten) enrolling in Ark Adventures Preschool Sunday School. In the fields above, please indicate the child's name along with the preferred email, home address and phone number for your family.:
*Name child goes by:
*Child's Gender:
*Child's Birthdate:
*Age on August 19, 2021:
Father's Name: Last, First:
*Mother's Name: Last, First:
Allergies/Health Concerns/Special Needs:
Serve Options::
I understand that children will not be released from The Ark without presentation of the security tag issued at the time of check-in each Sunday.:
*I understand the Security Tag requirement.:
In the event that my child has a medical emergency and I am unable to be reached, memorial Drive Presbyterian Church may obtain medical treatment for my child.:
*I agree with the Treatment Release:
Memorial Drive Presbyterian Church may use my child's name or picture in photos and/or video in promotional materials and/or on the the MDPC website regarding MDPC.:
*I agree with the Photo/Video Release:
Other Questions/Comments for Children's Ministry?: