Registration 2020/2021
Nursery, Children's Church, Sunday School, Junior High, Senior High registrations
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Child's First and Last Name *
Christian Education you are registering for (Check all that apply) *
Required
Birth Date* *
MM
/
DD
/
YYYY
Age and Grade on Sept 1, 2020 *
Gender *
Allergies (Food, Pets and/or Medication):
Medical Concerns (Asthma, seizures, etc.):
Other Concerns (learning disabilities, ADHD, ADD, discipline concerns, any physical or emotional disabilities):
Child lives primarily with:
Father's Full Name: *
Mother's Full Name: *
Primary E-mail: *
Home Address: *
Primary Phone (cell or home): *
Child's cell phone number (if applicable)
Health Insurance Company and Policy # *
Where will parent be located during Sunday School hour?
Do you give permission to EFC to post photos of your child on social media/website for the use of publicity or illustration? *
Health Permission:
I, the parent/guardian allow my child (above) to be involved in the Evangelical Free Church of Thief River Falls, MN ministry programs. I understand that all reasonable safety precautions will be taken at all times by the staff and volunteers. I understand the possibility of unforeseen hazards and the inherent possible risks.

I authorize treatment by licensed medical personnel deemed necessary for my child in the event of a medical or dental emergency. In consideration of the minor's participation in this event, I agree to release, indemnify and hold harmless area youth staff and the Free Church of Thief River Falls, its employees, volunteers, contracted, or otherwise from any liability for injury, disease, or damages from said participation.
Please sign with your full name if you agree with the above statement: *
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