C-STREET KIDS (a Ministry of College Street Baptist Church) Registration 2019-2020
* Required
I am Registering for:
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MARK Club (Sunday evenings)
Bible Quest (Wednesday evenings)
Both MARK Club & Bible Quest
Child #1 Name
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First and Last Name
Your answer
Child #1 Please list any food allergies that your child has:
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Your answer
Child #1 Please list any allergies/concerns that your child has:
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Your answer
Child #1 Age
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Your answer
Child #1 Current Grade
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K4
K5
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Child #2 Name
First and Last Name
Your answer
Child #2 Please list any food allergies that your child has:
Your answer
Child #2 Please list any allergies/concerns that your child has:
Your answer
Child #2 Age
Your answer
Child #2 Current Grade
K4
K5
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Clear selection
Child #3 Name
First and Last Name
Your answer
Child #3 Please list any food allergies that your child has:
Your answer
Child #3 Please list any allergies/concerns that your child has:
Your answer
Child #3 Age
Your answer
Child #3 Current Grade
K4
K5
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Clear selection
Parent/Guardian Name
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First and Last Name
Your answer
Complete Address/Apartment #
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Street Address with Apartment #, City, SC
Your answer
Cell Phone #
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Your answer
Email Address
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Your answer
OK to Photo/Video Your Child(ren) for Children's Ministry Related Purposes?
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Yes
No
Person(s) authorized to pick up your child
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Your answer
In Case of Emergency Contact Name
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First and Last Name
Your answer
Emergency Contact Phone #
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Your answer
Parent/Guardian Signature
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Submitting this form will serve as parent/guardian signature that your child (children) can attend College Street Baptist Church MARK Club Program 2019-2020 school year and permission to ride the church bus if applicable. Please type your First and Last Name
Your answer
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