CKC Registration '26-'27
Please complete one registration per child. Thank you!
Sign in to Google to save your progress. Learn more
Email *
Child Information
Name (First then Last) *
Birthday *
MM
/
DD
/
YYYY
Grade (Entering into Fall) *
Shirt Sizes
Clear selection
Medical Information
Does Your child take any medication? *
Please list all medications and it's purpose.
Does your child have any allergies? *
Please name the allergy and the necessary response.
Demographics
Parents Names (First and Last) *
Parents Phone Number
Please include the area code: (509-123-4567)
*
Mailing Address *
City *
State *
Zip Code *
Other Information
Emergency Contact
Please name someone we can contact if you can't be reached. (First then Last)
Emergency Phone
Please include the area code: (509-123-4567)
Home Church *
Consent Statements
CKC Photos
I grant permission for photos(s) of my child to appear among general club photos as long as there is no identifying information shown. (Example: Calvary Kids Club slide show.)
 *
Calvary Chapel Deer Park Photos
I grant permission for photos(s) of my child to appear Calvary Kids Club social media as long as there is no identifying information shown.

*
I understand that my child may participate in physical actives such as those held during Game Time. As with any physical activity, there is a risk of injury. I fully accept this risk and hold harmless from legal liability, Calvary Chapel Deer Park and any persons involved in the Calvary Kids Club ministry. *
In the event of an emergency that requires medical treatment for the above-named child, I understand every effort will be made to contact me or my emergency contact; however, if I cannot be reached, I give my permission to the Calvary Kids Club volunteers to secure the services of a licensed physician to provide the care necessary for my child's well-being. I assume financial responsibility for all costs connected to any accident or treatment of my child.
Clear selection
Reminder:

Calvary Kids Club is held at the Calvary Chapel Church located at 511 South Main St in Deer Park, WA.  Club will be held every Tuesday evening from 6pm to 8pm.  A club fee of $10 per child will be collected via cash or check. If you have any questions or concerns, please direct all questions to calvarykidsclubdeerpark@gmail.com
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms