Kid’s Ministry Registration Please select the appropriate tab below to fill out the Correct form Guests, please fill out the Guest Registration Form Members, please fill out the member Registration Form Guest Registration FormMember Registration Form NOTE – this form is for guests only. Members, please use the Member Registration Form (click member tab above). Name of Child* First Last Date of Birth* MM slash DD slash YYYY Age*<1123456789101112Grade*Pre-KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th GradeContact InformationAddress* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Cell Phone*Home PhoneMedical Information*List any food and/or allergies, medical conditions, or other helpful information we need to know. List who will be picking up your child:* Only people listed on this form are allowed to pick up the child. No one younger than 7th Grade and/or not related to you will be allowed to pick up your child. Please remember to bring your security badge with you to pick up your child or you may have to show your driver’s license for identification. Thank you for your cooperation!Click here to read the Kid's Ministry Reopening GuidelinesGuideline Agreement* By registering or entering our facility for childcare or activities for children, or serving within this ministry, you agree and understand that social distancing and wearing of masks by children and adults may not be possible at all times and we cannot guarantee the contraction from any type of contagious germs. Also, you agree and understand we may photograph or video your child for classroom crafts, church website, promotion, and presentations.Parent Name/Signature* CAPTCHA NOTE – this form is for members only. Guests, please use the Guest Registration Form (click guest tab above). Child's Name* First Middle Last Gender* Male Female Date of Birth* MM slash DD slash YYYY School Grade*Pre-KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th GradeAs of August, 2020 (if applicable)Parents/Guardians NamesParent/Guardian Name 1* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Cell Phone*Home PhoneParent/Guardian Name 2 First Last Address 2 (if different than above) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email 2 Cell Phone 2Home Phone 2Medical Information*List medical, medicines taken on a regular basis, or other information we need to know regarding the care of your child. Please include any medicine or food allergies, anxieties or fears and list specific details. Emergency Contacts:*NamePhone Number Dismissal Information: Please list who may pick up your child:* Only people listed on this form are allowed to pick up the child. No one younger than 7th Grade and/or not related to you will be allowed to pick up your child. Please remember to bring your security badge with you to pick up your child or you may have to show your driver’s license for identification. Thank you for your cooperation!Click here to read the Kid's Ministry Reopening GuidelinesGuideline Agreement* By checking this box and typing your name, you are agreeing to the following:By registering or entering our facility for childcare or activities for children, or serving within this ministry, you agree and understand that social distancing and wearing of masks by children and adults may not be possible at all times and we cannot guarantee the contraction from any type of contagious germs. Also, you agree and understand we may photograph or video your child for classroom crafts, church website, promotion, and presentations.Parent Name/Signature* CAPTCHA
