2018-2019 Sunday School

Registration & Authorization Form

Parent/Guardian Name: ______________________________________________________________

Street Address: _______________________________________________________________________

City/State/Zip Code: _________________________________________________________________

Home Phone#_____________________________ Cell Phone #_____________________________

Emergency Contact Name: _________________________Phone #_________________________

Email Address: _______________________________________________________________________

1st Child Name: ________________________Date of Birth ___________ Grade in Fall_______

2nd Child Name:_______________________ Date of Birth ___________ Grade in Fall_______

3rd Child Name:_______________________ Date of Birth ___________ Grade in Fall_______

4th Child Name:_______________________ Date of Birth ___________ Grade in Fall_______

Tuition Information: (Book fees are included in tuition)

$600 ($550 for second child) if registered and paid after July 1st

$550 ($500 for second child) if registered and paid in full before July 1st

Registration forms and checks may be mailed to the following address:

Dr. Hamadeh, 6447 Shady Ln., Burr Ridge, IL 60527

*Families requesting financial assistance will need to fill out a scholarship application.

Mecca Center Sunday School

Authorization​ ​Form

Please sign that you have read, understood and agreed to each of the following:

❖ I authorize the Mecca Center Sunday School staff to provide my child with any Emergency Medical Care, including transferring him/her to a nearby emergency facility, when I or my spouse cannot be reached. I will be responsible for the medical charges.

Parent​ ​Signature​ ​______________________________​ ​Date​ ​__________________

❖ I authorize the Mecca Center Sunday School staff to photograph or videotape my child in any activities and to use photographs and videos in presentations or other promotional material.

Parent​ ​Signature​ ​______________________________​ ​Date​ ​__________________

❖ I authorize my child to participate in any activity that may be hosted by private or public transportation *(any activity that requires leaving the premises of the center will be notified by another slip) *

Parent​ ​Signature​ ​______________________________​ ​Date​ ​__________________

Student Food Allergy & Sensitivity Disclosure

Please check off the appropriate statement:

I authorize the Mecca Center Sunday School staff to provide my child with edible snacks or treats. My child does not have any known food allergies or sensitivities.

My child has the following food allergies and/or food sensitivities that the Mecca Center Sunday School staff should be made aware of:

Food Name ___________________ Nature of Allergic Reaction ______________

Parent​ ​Signature​ ​______________________________​ ​Date​ ​__________________