REGISTRATION - Spring Hill Church of Christ

Please note that all 2024-25 Tuesday School classes are full.

Tuesday School Registration 2024

Child's Name*
First Last
Please tell us your Child's Gender*
- Boy
- Girl
Child's Date of Birth*
Month
Day
Year
Name of Parent/Guardian
First Last
Parent/Guardian's Address*
Street Address Address Line 2 City State ZIP Code
Parent/Guardian's Phone Number*
Relationship to Student*
Parent/Guardian's Preferred Email
Enter Email Confirm Email
Name of Alternate Emergency Contact
First Last
Alternate Emergency Contact Number
Relationship to Student*
Child & Parent/Guardians
- All reside at the same address
- Do not all reside at the same address
2nd Address
Street Address Address Line 2 City State ZIP Code

We do not ask for or assume knowledge of custody situations. Please fill out this 2nd address if the child's parents live separately.
Additional Important Information (read info below box)*
Any allergies/medications your child is allergic to; Medications your child is taking; Physical or mental conditions; Illnesses or chronic conditions; Anything else Tuesday School should be aware of in regard to your child.
Is there anything that your child may not have as a snack or drink?
Is there any activity in which your child should not engage?
Please provide a list of adults who are allowed to pick up your child and their relationship:
When one of those listed are picking up your child, please send a note prior to the pick up stating who will be picking your child up and what the date of pick up will be.
Emergency Treatment Consent - Read carefully below*
- I agree
I give my consent for the Spring Hill Church of Christ Tuesday School staff to provide emergency treatment for my child in the event of an accident, injury, or serious health condition occurring while at the school. Every attempt will be made to contact the guardian/emergency contact. If contact to a parent, guardian, or emergency contact cannot be made, child will be transported to the nearest hospital for emergency treatment at your expense for the treatment.
Name of Parent/Guardian Completing Form*
First Last
Date of Form Submssion*
MM slash DD slash YYYY

*Please make your $70 check payable to "Spring Hill Church of Christ" and mail it to the following address:
Tuesday School c/o
Spring Hill Church of Christ
2021 Brell Drive
Middletown, Ohio 45042
Or just bring the check/cash with you to the Open House or the first day of class on September 3, 2024.