Registration

Child’s Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Parent/Guardian’s Name *

First Name

Last Name

Participation *

I give permission for my child to participate fully in the Kids ministry programs of Life Church, including snacks and games. In case of emergency, I understand that every effort will be made to contact parents/guardians of the child. In the event that I cannot be reached, I hereby give permission for the medical personnel selected by the Kids Ministry Teacher/Volunteers to secure proper and necessary treatments for my child as named in the form.

Media *

I understand that during the course of the year, photographs or videos may be taken to help us remember the activities of the year. I give permission for my child’s photograph and/or video to be used in our church publication such as newsletter, website and online and printed promotional material.

I understand that during the course of the year, photographs or videos may be taken to help us remember the activities of the year. However, I DO NOT GIVE PERMISSION for my child’s photograph and/or video to be used in our church publication.