Nursery / Sunday School Enrollment

If you submit your enrollment form before Thursday at 12pm, you will be able to check-in using the electronic kiosks the following Sunday. If your information is submitted after Thursday at 12pm, you may not be in the system until the following week. Please contact Lanie Pettes at pettesl@hpumc.org with any questions.

Child's Name (First & Last)*

Birthdate*

Sex*

Age or Grade as of Sept 1, 2011*

Family Email Address*

School Attending as of September 1, 2011*

Street Address*

City*

State*

Zip*

Home Phone*

Mother's Name*

Mom's Address (if different from child)

Mom's Cell Phone

Father's Name*

Father's Address (if different from child)

Father's Cell Phone

Describe allergies, limitations or special needs, which we should be aware of.

Which hour/hours will your child be attending?

Where will you be located during the above hour/hours?

	To prevent spam, please tell us: What is one plus eight?*