CCIC-NV Children Ministry Registration Form
"5 I am the vine; you are the branches. If a man remains in me and I in him, he will bear much fruit; apart from me you can do anything." (John 15:5)
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Mom's Name *
Mom's cell phone *
Email *
Dad's Name
Dad's cell phone
Email
Mailing Address *
Emergency Contact *
Cell Phone *
Visitor *
Language Preference *
CCICNV small group
Child 1 Name: *
Grade *
Gender *
Birth date *
MM
/
DD
/
YYYY
School
Known allergies *
Child 2 name
Grade
Clear selection
Gender
Clear selection
Birth date
MM
/
DD
/
YYYY
School
Known allergies
Child 3 Name
Grade
Clear selection
Gender
Clear selection
Birth date
MM
/
DD
/
YYYY
School
Known allergies
Sunday school & Children Worship (check all classes your child will attend *
Required
I give permission for my sons and/or daughters to participate fully in the Sunday school program at CCICNV, including snacks and games.  In case of an emergency, I understand that every effort will be made to contact the parents/guardians of the child(ren).  In the event that I cannot be reached, I hereby give permission for the medical personnel selected by the Sunday school staff to secure proper and necessary treatment for my child(ren) as named on this form.
Signature and date below:
In order to run Sunday school smoothly, your help is needed.  A parent/guardian of each child will be scheduled to help in a class.  For the safety of all children, all leaders and helpers are required to complete a simple background check.
Signature and date below:
 *
Submit
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