MCH New Family Registration Form

New Family Registration Form

* Indicates required field

Family Last Name *

Home Phone Number (If Available) *

Mom's Name *

Dad's Name *

Mom's Occupation (If applicable; other than homeschooling or homemaking) *

Dad's Occupation *

How Many years have you been homeschooling? *

Home Church *

How Did you hear about MCH? *

Please list any prior teaching and/or classroom help experiences outside the home, whether it be through other schooling methods, church, community, etc.

Email *

Mom Cell Phone *

Dad Cell Phone *

If working, is mother's position *

Is dad's position *

Which Grades/Levels Have You Homeschooled? *

What Year Did You Join Your Church? *

Why do you wish to join a homeschool cooperative effort? *

Comment *

Child Information

Please list your child(ren)’s names and ages under the corresponding classes. Munchkins will be promoted to Preschool at
the time of their second birthday. Please note there is a minimum age requirement for Elementary and Intermediate classes
to ensure appropriate social, mental, emotional, and physical group interactions in the classroom and PE situations:

Munchkins (ages 0-2)

Munchkins will be promoted when they begin a semester as a three year old.

Name *

Current Age *

Current age *

Birthdate (MM/DD/YY) *

Preschool (ages 3-5)

Name *

Current age *

Birthdate (MM/DD/YY) *

Elementary (grades k-3, minimum age required is 5)

Name *

Current age *

Birthdate (MM/DD/YY) *

Intermediate (grades 4-6, minimum age required is 9)

Name *

Current age *

Birthdate (MM/DD/YY) *

Food Allergies

We will post a laminated card in your child’s classroom with the following information:

Name *

Allergy *

Reaction/Medication/Instructions: *

Name *

Allergy *

Reaction/Medication/instructions: *

Name *

Allergy *

Reaction/medication/instructions *

Medical

Please note if there are any medical conditions that we need to be aware of:

Name *

name *

Notes about medical condition *

Special Needs

Please note if there are any learning or physical challenges so the leaders can better serve your family.

Name *

Learning or physical challenges to be aware of: *

First Aid/CPR

This is not a requirement but helpful information for safety purposes. Thank you.

Schedule

The MCH season will begin September 7, 2023 and finish May 2, 2024 with breaks throughout for various reasons. To the best of your knowledge, what is your commitment level?

Select One *

The MCH core schedule is as follows:
11:00 Assembly
11:15 Enrichment
12:00 Lunch and Recess
12:45 PE
1:45 Cleanup
2:00 Dismissal

Each family is asked to commit to this core schedule, outside of sickness and emergencies.

I agree (Please Initial) *

Our 10:00 AM Science class is optional. Will your family be attending? A Munchkin Class will be offered at this time.

Select One *

Parental Involvement

MCH is not currently a drop-off service. Each parent is expected to stay and help in some capacity.

All classroom participants must have their PA Clearances up to date and provide a copy of them to MCH for the Monroeville
Christian Church Secretary to keep on file. No one will be permitted to work in a classroom without such clearances.

I agree (please initial) *

I agree to pay all class fees and submit a copy of my PA clearances by August 1st.

I agree (Please Initial) *

Fees

MCH is free to join, however, there may be class fees associated with specific classes. In such cases, money would be paid
directly to the teacher for compensation of supplies personally purchased and/or time if the class is labor intensive. Donations to MCH are accepted for the purchase of supplies that benefit the group. Monetary donations are accepted via online giving or by sending to the Monroeville Christian Church office.

Agreement

The information on this form is true to the best of my knowledge. My family and I have read the current MCH
Guidelines and agree to uphold them.

Name *

First

Last

Date *

New Family Registration Form

Child Information

Munchkins (ages 0-2)

Preschool (ages 3-5)

Elementary (grades k-3, minimum age required is 5)

​Intermediate (grades 4-6, minimum age required is 9)

Food Allergies

Medical

Special Needs

First Aid/CPR

Schedule

​Parental Involvement

Fees

Agreement

Intermediate (grades 4-6, minimum age required is 9)

Parental Involvement