Prattville First Methodist Church

Student Enrollment Form for 2025-2026 School Year
at Prattville First Methodist Church

Student First Name

Student Last Name

Mother's First Name

Mother's Last Name

Mother's Phone Number

Phone number type

Home

Cell / Mobile

Work

Mother's Email

Father's First Name

Father's Last Name

Father's Phone Number

Phone number type

Home

Cell / Mobile

Work

Father's Email

Student Birthdate

Grade

Gender

Male

Female

Allergies

Any known medical problems? Please specify:

Emergency Contact Name

Emergency Contact Phone Number

Physician's Name / Group:

Physician Phone Number

People Authorized to Pick-up My Child

Relationship to Child

Phone Number

People Authorized to Pick-up My Child

Relationship to Child

Phone Number

Staff and/or volunteers cannot permit a child to leave with anyone not authorized by the parent or guardian signing this form. If a change is necessary, the parent or guardian MUST provide a written notice in advance.

Name of Parent Signing Authorization Form

Signature

Date Signed

Student Enrollment Form for 2025-2026 School Year
at Prattville First Methodist Church

About

Service Times

Contact Info

Follow Us

Student Enrollment Form for 2025-2026 School Yearat Prattville First Methodist Church

About

Service Times

Contact Info

Follow Us

Student Enrollment Form for 2025-2026 School Year
at Prattville First Methodist Church