1.First and Last Name of Parent(s)/Guardian

2.Email of Parent(s)/Guardian

3.Home Number of Parent(s)/Guardian

4.Cell Number of Parent(s)/Guardian

5.Age of child/Ages of children

6.Grade of child/Grades of children

7.Are parent(s)/guardian a member of Central UMC?

8.Is child a member/Are children members of Central UMC?