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Registration for Tuesday Night Kids Group
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Registration for Tuesday Nights Kids Group
Basic Info
Child's Name
First
Last
Child's Gender
- Select -
Boy
Girl
Child's Date of Birth
Grade
?
Please describe any allergies, medications, medical conditions, physical or behavioral challenges, or other concerns.
Parent/Guardian
Parent/Guardian
Name
Email
Phone
Address
Address 2
City/Town
State/Province
- None -
ZIP/Postal Code
Emergency Information
Alternate Contact Person (in case of emergency)
Emergency Phone Number
Relationship to Child
Legal Stuff
Photos/videos may be taken of my child for craft projects and in-church purposes.
Photos and video may be taken of my child for craft projects and in-church purposes.
Photos/videos may be taken for use on the church webpage and Facebook.
Photos and video may be taken for use on the church webpage and Facebook.
Waiver
As a parent or legal guardian of the above child, I authorize a representative of Homewood Evangelical Free Church to consent to all medical treatment as deemed advisable in the opinion of the attending physician in the event of a medical emergency. I give permission for the above named child to participate in all Kids Group activities. I waive and release Homewood Evangelical Free Church and any of its staff and volunteers from any and all liability for injury or illness.
Signature (first and last name)
Signature Date
I agree
By typing my name and checking this box, I am signing this application electronically. I agree that my electronic signature is the legal equivalent of my manual signature on this application.
WE ARE ASKING EVERYONE TO WEAR A MASK DURING KIDS GROUP ACTIVITIES.
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