Church School Registration Form

This form is not submitted over the internet. Please fill in your answers, print out the form and either bring it on "Registration Sunday" or mail it to the church office:
Riverdale Presbyterian Church
4765 Henry Hudson Parkway West
Bronx, NY 10471
Mother's name:
Father's name:
Address: Street Apt.
  City , State Zip
Telephone
Home
Work
Cell
Additional Telephone Numbers:
e-mail address
additional e-mail
Please check: Member of Riverdale Presbyterian Church
Child(ren)'s Information
#1 Name: First Middle Last:
Nickname:
Date of Birth (mm/dd/yyyy):
Grade:
Allergies:
Is this child baptized?
No
 
#2 Name: First Middle Last:
Nickname:
Date of Birth (mm/dd/yyyy):
Grade:
Allergies:
Is this child baptized?
No
 
#3 Name: First Middle Last:
Nickname:
Date of Birth (mm/dd/yyyy):
Grade:
Allergies:
Is this child baptized?
No
Please check one:
No, I do not
...give my permission for photographs of my child to be used for publications, the RPC web site, or other church-related items used for communication and/or publicity purposes of Riverdale Presbyterian Church.
Who will pick up your child(ren) after school?
#1
#2
#3