Heritage Christian School A Ministry of First Baptist Tillmans Corner Heritage Christian School A Ministry of First Baptist Tillmans Corner Heritage Christian School Calendar Heritage Christian School A Ministry of First Baptist Tillmans Corner Heritage Christian School A Ministry of First Baptist Tillmans Corner Heritage Christian School A Ministry of First Baptist Tillmans Corner
 

Co-Op Registration Form

* indicates a required answer.

1. *

Parents' Last Name

2. *

Parent's First Name

3. *

Street Address

4. *

City

5. *

State

6. *

Zip Code

7. *

Phone Number

8. *

Cell Phone Number

9. *

Email Address

10. *

Name of Church Family Attends

11. *

Student #1 Last Name

12. *

Student #1 First Name

13. *

Student #1 Birthday

14. *

Student #1 Age

15. *

Student #1 Grade Level

16. *

Student #1: Does this student have any learning disabilities, physical disabilitis, allergies, or medical concerns? Please explain.

17.

Student #2 Last Name

18.

Student #2 First Name

19.

Student #2 Birthday

20.

Student #2 Age

21.

Student #2 Grade Level

22.

Student #2: Does this student have any learning disabilities, physical disabilities, allergies, or medical concerns? Please explain.

23.

Student #3 Last Name

24.

Student #3 First Name

25.

Student #3 Birthday

26.

Student #3 Age

27.

Student #3 Grade Level

28.

Student #3: Does this student have any learning disabilities, physical disabilities, allergies, or medical concerns? Please explain.

29.

Student #4 Last Name

30.

Student #4 First Name

31.

Student #4 Birthday

32.

Student #4 Age

33.

Student #4 Grade Level

34.

Student #4: Does this student have any learning disabilities, physical disabilities, allergies, or medical concerns? Please explain.

35. *

I understand that I must attend co-op with my child(ren). I, also, understand that I must volunteer to help in at least 2 co-op classes each week. Co-op will be made a priority, and we will take each class very serious. I will make sure my child(ren) are prepared each week for their classes. I will keep a positive attitude toward the co-op, teachers, and classes. If any issues arise, I will go to the co-op director immediately. My name and date in the box belows shows my consent to the above.

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