FCC Church School Registration 2025-2026

Child Information

Child's Name

Child's Date of Birth

Child's Address

Medical Information: Please list any allergies and/or other health concerns.

In case of an emergency, I understand that every effort will be made to contact me. If I cannot be reached, I hereby give FCCS my permission to act on my behalf in seeking emergency treatment for my child in the event that such treatment is deemed necessary. I give permission to those administering emergency treatment to do so, using those measures deemed necessary. I release First Congregational Church of Southington from liability in acting on my behalf in this regard. Please type initials below.

Special Concerns: To provide the best church school experience we can for your child, please use the space below to make us aware of any special needs your child(ren) may have. You can also discuss any concerns you may have directly with the Director of Christian Education. All information is held in confidence and shared only with classroom teachers & volunteers with permission. Please type "none" if you have no additional concerns to share.

Parent/Guardian Information

Parent/Guardian 1 Name

Phone

This address will receive a confirmation email

May we add you to our First Congregational Church of Southington weekly All Church Update and Church School email list? Please indicate

Yes No

Parent/Guardian 2 Name

Phone

May we add you to our First Congregational Church of Southington weekly All Church Update and Church School email list? Please indicate Yes No

Emergency Contact (other than parent/guardian listed above) Type name below.

Emergency Contact Phone

Relationship to child. Type below.

Are there any persons to which the child (children) may NOT be released to? Who may you child (children) NOT be released to? (Type below.) Please note a copy of a protective order may be required to restrict access.

Media Release

In order to share the good news of the mission and ministry of First Congregational Church of Southington, we occasionally use images (photo/video) of students in classrooms or during special programs, or sent to FCCS by parents/guardians. These images may be shared on church bulletin boards, newsletters, in local newspapers or other printed materials, on our website, social media (email communications, live-stream events, Facebook, Instagram, YouTube, etc.), or in presentations during worship. If you are comfortable with the use of your child(ren)’s and/or youth(s)’s images for these purposes, please indicate below.

I hereby give permission for First Congregational Church of Southington to take and use images of my child(ren)/youth (photo or video) taken during church-related activities, or shared by me with FCCS staff, for church purposes only as described above. No children/youth will be identified by name. I understand that I will be contacted for special permission should any photo be considered for use other than described above.

I agree. I disagree. Please contact me for permission.

Parent/Guardian Covenant

I understand that many volunteer hands are needed. I covenant to use my gifts in some way this program year to support the Church School & Nursery of FCCS. As a partner in this ministry, I pledge to uphold and support my child’s involvement in all aspects of participation including supporting the Church School teachers in their efforts to teach this year.

Choose all that apply. I am interested in: Church School volunteer Nursery Care volunteer Serve on the Board of CE

FCC Church School Registration 2025-2026

Description

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