Girls in Action Registration
Please fill out emergency, medical, and other information about your daughter who will be in GA's.
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Email *
Child's name *
Date of Birth *
Grade in school *
Allergies or other necessary medical information *
T-shirt size *
List any medications and dosage that leaders have permission to give your child if needed: *
Parent/Guardian Name *
Phone #
What location in the church will the parent/guardian be on Wed. nights?
Emergency Contact name
Emergency Contact phone #
Please list names of people other than parents allowed to pick your child up:
Insurance Company
Insurance Policy #
Family Physician
May we have permission to photograph your child and use photos for our church website, social media, or any other promotion? *
Are there any other concerns you'd like to share with us about your child?
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