Toddler Registration — Christ Our Savior Lutheran

Toddler Time Registration

Teacher: Amy Sullivan coskidsrock@gmail.com 616 308-1550

$25 registration fee due when you submit this form

Fall: 14 sessions= $140 (due first class) Winter: 16 sessions= $160

Full Name (first middle last)

Name to use in class and on folder

Date of Birth

YYYY

Gender

Male

Female

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mother's Name

Mother's Phone

(###)

###

####

Father's Name

Father's Phone

(###)

###

####

Email Address to be used for class correspondence

Second Email Adress (if you would like both parents to get correspondence)

Adult who plans to attend most sessions (substitute adults are welcome)

Church you regularly attend

Child Baptized

Yes

Other persons living in the home

Include siblings and ages

Is there anything else we should know?

Allergies, behavioral, speech concerns, living arrangements, etc...