Kid's Bridge - Registration Form
A NEW look at Caravan
Email address
Parent's first & last name
Your answer
Child's first & last name
Your answer
Child's birth date (including year)
Your answer
Child's grade (if applicable)
Your answer
Address, including zip code
Your answer
Phone number (to be used in case of emergency)
Your answer
2nd Emergency contact phone number
Your answer
Is there any custody information we need to be aware of?
Your answer
Who has permission to pick up your child?
Your answer
Are there any allergies or medical conditions we need to be aware of?
Your answer
What area do you think your child will want to participate in?
I grant permission for my child to use all play equipment and to participate in all activities through the Kid's Bridge program and will not hold liable South Portland Church of the Nazarene, it's employees, or it's volunteers for any injuries sustained.
We grant permission for our child to have his/her picture taken or videotaped for use on the SPCN web site and social media sites.
I grant permission for my child to leave the SPCN campus for a fieldtrip with prior notification.
Please complete the captcha before submitting the form.
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