Kingdom Kids 2020/2021 Registration
Welcome to Kingdom Kids! We can't wait to see what God will do this year! Please fill out the information below to register your child for the 2020/2021 year!
Childs Name (If you have more than one, please fill out a separate form)
Gender
Clear selection
Date of birth
MM
/
DD
/
YYYY
Age
Grade
Parent/ Caregiver name
Address
City
State
ZIP
Email
Home/Cell Phone
Okay to text this number?
Clear selection
Emergency Contact
Phone
Allergies or other concern
I give Koerner Heights Church permission to:
make visual images (photographs, movies, videos) and audio recordings of my child and to use visual images and audio recordings on the koernerheights.org website, in printed or electronic marketing materials, in social media, or in other audio or visual communications, and I release Koerner Heights Church from any and all liability related thereto. Koerner Heights Church will keep any and all personal information regarding my child confidential and will not disclose or utilize it for any purposes other than Koerner Heights Church internal records and marketing purposes. PLEASE NOTIFY KOERNER HEIGHTS CHURCH IN WRITING IF YOU WOULD LIKE TO WITHHOLD YOUR PERMISSION FOR THE USE OF YOUR CHILDS IMAGES.
Electronic Parents Signature
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