Please fill out and submit this form by using the button at the bottom of page. If you have feedback or comments, or you'd like further information, contact Channing's Director of Religious Education, Halcyon Westall dre@channingchurch.org.
Please note that we expect ALL families to teach in our Religious Education Program. With this registration form, please complete a teaching team preference form and the Background Check and Code of Ethics forms for working with children and youth in our program.
Family Name . . . . . . .
Street_Address. . . . . .
City_State_Zip . . . . . .
Phone_Number . . . . . .
How would you like to be contacted? Email - Phone - or Mail?
Please enter child's information:
Child 1 - Name - Date of Birth - Grade (Fall 2010)
Child 2 - Name - Date of Birth - Grade (Fall 2010)
Child 3 - Name - Date of Birth - Grade (Fall 2910)
Child 4 - Name - Date of Birth - Grade (Fall 2010)
Please provide the following contact information, should we need to reach someone quickly.
Parent/Guardian_1 (Name, Email, Cell Phone)
Parent/Guardian_2 (Name, Email, Cell Phone)
Parent/Guardian_3 (Name, Email, Cell Phone)
Does the child have any known alergies? Any medications we should be aware of? Please give details.