Resurrection CGS Registration

Mother's First and Last Name REQUIRED Please fill out this field. Please enter valid data.

Mother's Phone Number REQUIRED Please fill out this field. Please enter valid data.

Father's First and Last Name REQUIRED Please fill out this field. Please enter valid data.

Father's Phone Number REQUIRED Please fill out this field. Please enter valid data.

Legal Guardian Name and Number Please enter valid data.

Registered Parish REQUIRED Please fill out this field.

Email REQUIRED Please fill out this field. Please enter an email address.

Additional Email (only if you want communications sent to more than one person) Please enter valid data.

Child #1 Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Student Grade this Fall REQUIRED Please fill out this field.
School Attending in Fall REQUIRED Please fill out this field.
Class Choice REQUIRED
Choose one option
3-5 yr old: Tuesdays 10:00-11:30 AM 3-5 yr old: Wednesdays 3:30-5:00 PM Kindergarten: Wednesdays 5:15-6:30 PM None of the times work. Put me on a waitlist. Please fill out this field.
Additional Information (learning difficulties, special education, severe allergy, etc.)
MEDIA RELEASE & AUTHORIZATION REQUIRED
I understand that by responding "Yes" I hereby grant authority to my child’s parish for the use of any videos, photos, or similar items to used in social media or on a parish web page.
YES NO Please fill out this field.
PARTICIPANT INFORMATION RELEASE REQUIRED
I understand that by responding "Yes" I hereby grant authority to my child’s parish for the publication of participant information in the parish directory and other parish publications.
YES NO Please fill out this field.

Child #2 Information

First Name Please enter valid data.

Last Name Please enter valid data.
Student Grade this Fall
School Attending in Fall
Class Choice
Choose one option
3-5 yr old: Tuesdays 10:00-11:30 AM 3-5 yr old: Wednesdays 3:30-5:00 PM Kindergarten: Wednesdays 5:15-6:30 PM None of the times work. Put me on a waitlist.
Additional Information (learning difficulties, special education, severe allergy, etc.)
MEDIA RELEASE & AUTHORIZATION
I understand that by responding "Yes" I hereby grant authority to my child’s parish for the use of any videos, photos, or similar items to used in social media or on a parish web page.
YES NO
PARTICIPANT INFORMATION RELEASE
I understand that by responding "Yes" I hereby grant authority to my child’s parish for the publication of participant information in the parish directory and other parish publications.
YES NO

ELECTRONIC SIGNATURE

Please check one of the following: REQUIRED NO, I am unwilling to sign this form electronically. I understand that I must contact the parish office for a hardcopy of the above permissions before the child or children listed above can participate in the program. YES, I am the parent or guardian of the child(ren) named above and have the legal authority to execute the above permission(s). I consent to signing this document electronically as demonstrated by typing my name. Please fill out this field.
First Name Please enter valid data.

Last Name Please enter valid data.

Church of the Resurrection