Children and Youth Registration Form
Hello Parents! Please take a moment to fill out the 2016-17 Registration Form for any of Old South's children's or youth programs, including Worship Workshop (Sunday School), nursery, and youth events. Please note that we do not share any information, this is just for your child's safety and care.
Family Information
Name of Parent/Guardian 1
Your first and last name
Your answer
Name of Parent/Guardian 2
First and last name
Your answer
Home Phone Number
Please include area code
Your answer
Home Address
Street, City, Zip
Your answer
Parent 1 Email Address
Your answer
Parent 2 Email Address
Your answer
Parent 1 Cell Phone
(Or first number to call in case of emergency)
Your answer
Parent 2 Cell Phone
(Or second number to call in case of emergency)
Your answer
Additional Emergency Contact (in case parents cannot be reached)
First & Last Name, Phone, Relation to child
Your answer
Photography Permission
Please type your initials below to agree, and/or specify any exclusions to the following statement: I give my permission for photographs or video of my child to be used by the church for worship services (slide shows), printed visuals (bulletin boards, brochures), digital publicity (email updates, the church website, the church Facebook page, youtube), at the discretion of Pastor Carol and other trusted church leaders. I understand that I may request at any time for a specific image to be removed from such places. I also understand that the worship service is taped and distributed to the local cable channel.
Your answer
Child 1 Info
Please register your children in age order, from youngest to oldest
Child 1 Name
First and Last
Your answer
Child 1 Date of Birth
MM/DD/YYYY
Your answer
Child 1 Special Info
Allergies, medical conditions, learning disabilities, dietary restrictions, or anything else we should be aware of.
Your answer
Child 1 Grade
For the 2016-17 School Year
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This form was created inside of Old South United Methodist Church. Report Abuse - Terms of Service - Additional Terms