Cigar night 2026

Child's Full Name

Child's name in Greek (if applicable)

Child's patron saint

Address (Street, City, State, Zip Code)

Phone number

Email

Date of Birth

Child's nameday

Orthodox Baptismal Date

Child's grade entering this coming school year

Parent contact (Full name, Cell number)

Emergency Contact (other than parent) (Full name, Cell number, Relation)

Allergies

Medical conditions / Concerns

Does child have EpiPen?

Yes
No

Is there anything you would like us to know about your child?

saint City, (Full

If I am not available, and a medical emergency arises, the supervising teacher has my permission to seek medical help.

I give permission my child's picture to be uploaded for classroom projects, social media and/or the church website

Child's Full Name

Child's name in Greek (if applicable)

Child's patron saint

Address (Street, City, State, Zip Code)

Phone number

Email

Date of Birth

Child's nameday

Orthodox Baptismal Date

Child's grade entering this coming school year

Parent contact (Full name, Cell number)

Emergency Contact (other than parent) (Full name, Cell number, Relation)

Allergies

Medical conditions / Concerns

Does child have EpiPen?

Yes
No

Is there anything you would like us to know about your child?

Greek nameday name,

If I am not available, and a medical emergency arises, the supervising teacher has my permission to seek medical help.

I give permission my child's picture to be uploaded for classroom projects, social media and/or the church website

Child's Full Name

Child's name in Greek (if applicable)

Date in

Child's patron saint

Address (Street, City, State, Zip Code)

Phone number

Email

Date of Birth

Child's nameday

Orthodox Baptismal Date

Child's grade entering this coming school year

Parent contact (Full name, Cell number)

Emergency Contact (other than parent) (Full name, Cell number, Relation)

Allergies

Medical conditions / Concerns

Does child have EpiPen?

Yes
No

Is there anything you would like us to know about your child?

If I am not available, and a medical emergency arises, the supervising teacher has my permission to seek medical help.

I give permission my child's picture to be uploaded for classroom projects, social media and/or the church website

Child's Full Name

Child's name in Greek (if applicable)

Child's patron saint

Address (Street, City, State, Zip Code)

Phone number

Email

Date of Birth

Child's nameday

Orthodox Baptismal Date

Child's grade entering this coming school year

Parent contact (Full name, Cell number)

Emergency Contact (other than parent) (Full name, Cell number, Relation)

Allergies

Medical conditions / Concerns

applicable) Child's Does

Does child have EpiPen?

Yes
No

Is there anything you would like us to know about your child?

If I am not available, and a medical emergency arises, the supervising teacher has my permission to seek medical help.

I give permission my child's picture to be uploaded for classroom projects, social media and/or the church website

Child's Full Name

Child's name in Greek (if applicable)

Address (Street, City, State, Zip Code)

Phone number

Email

Date of Birth

Age

Grade in school

Orthodox Baptismal Date

Baptismal Name

Parent contact (Full name, Cell number)

Emergency Contact (other than parent) (Full name, Cell number, Relation)

Allergies

Medical conditions / Concerns

Does child have EpiPen?

Yes
No

Is there anything you would like us to know about your child?

in about parent)

If I am not available, and a medical emergency arises, the supervising teacher has my permission to seek medical help.

I give permission my child's picture to be uploaded for classroom projects, social media and/or the church website

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