MCH Returning Family Registration Form

Returning Family Registration Form

* Indicates required field

Family Last Name *

How many years have you been homeschooling? *

Which grades/levels? *

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 *

Birthday (MM/DD/YY) *

Name *

Current age *

Birthday (MM/DD/YY) *

Preschool (Ages 3-5)

Name *

Current Age *

Birthday (MM/DD/YY) *

Name *

Current Age *

Birthday (MM/DD/YY) *

Elementary (Grades K-3, Minimum age required is 5)

Name *

Current Age *

Birthday (MM/DD/YY) *

Name *

Current Age *

Birthday (MM/DD/YY) *

Name *

Current Age *

Birthday (MM/DD/YY) *

Intermediate (Grades 4-6, Minimum age required is 9)

Name *

Current Age *

Birthday (MM/DD/YY) *

Name *

Current Age *

Birthday (MM/DD/YY) *

Food Allergies

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

Name *

Allergy *

Name *

Allergy *

Name *

Allergy *

Reaction, Medication, Instructions: *

Reaction, Medication, Instructions *

Reaction, Medication, Instructions: *

Medical

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

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: *

Name *

LEARNING OR PHYSICAL CHALLENGES TO BE AWARE OF: *

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.

Updates

Are there any other updates to your family's information that MCH needs to know to better serve you?

Comment *

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 & 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. A Munchkin class will be offered during this time. Will your family be attending?

Select One *

Parental Involvement

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

I agree (Please initial:) *

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 *

Date *

Submit