Sunday School Allergies & Special Needs Disclosure
Child Information
Child's Full Name
Date of Birth
Parent/Guardian Information
Parent/Guardian Name
Contact Number
Email Address
Allergies
List any food, medication, or environmental allergies
Instructions in case of an allergic reaction
Medical/Special Needs
Medical conditions or special needs
Required accommodations or instructions
Emergency Contact (Other than Parent/Guardian)
Name
Phone Number
Other information church staff should know
Parent/Guardian Signature
Date