Child Registration Form
Please fill this form out so we can best care for your child.
Parent or Legal Guardian Name *
Email *
Phone Number (s) *
Address *
Name of Child 1
Gender of Child 1
Clear selection
Birthday of Child 1
Grade (Preschool - 5th) of Child 1
Medical Info and Allergies of Child 1
Name of Child 2
Gender of Child 2
Clear selection
Birthday of Child 2
Grade (Preschool - 5th) of Child 2
Medical Info and Allergies of Child 2
Name of Child 3
Gender of Child 3
Clear selection
Birthday of Child 3
Grade (Preschool - 5th) of Child 3
Medical Info and Allergies of Child 3
Name of Child 4
Gender of Child 4
Clear selection
Birthday of Child 4
Grade (Preschool - 5th) of Child 4
Medical Info and Allergies of Child 4
COVID-19 Release: I (the Parent or Guardian) know that any public or social activity inherently carries the risk of me or my child (or children) contracting COVID-19. By choosing to participate in this activity, I therefore release Union Baptist Church, Kids Crew Ministry, and it’s volunteers from any liability regarding COVID-19. *
Required
Sport or Play Injury Release: I (the Parent or Guardian) know that any sport or recreational activity carries an inherent risk of injury to my child (or children). By choosing to participate in this activity, I therefore release Union Baptist Church, Kids Crew Ministry, and it’s volunteers from any liability regarding injury. *
Required
Media Release: I (the Parent or Guardian) authorize the use of images of my child/children (photos or videos) by Union Baptist Church for any lawful purpose, including such purposes as publicity, illustration, advertising, social media (including but not limited to Facebook), etc. in print or electronic form. *
Required
Are you the parent or legal guardian of the children you are registering? *
Required
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