Kingdom Kidz Registration Form

Child's Name

Mother's Name

Father's Name

Parent's Email

This address will receive a confirmation email

Parent's Phone

Address

What school does your child attend?

Is there any toileting information that we need to be aware of?

Medical History

Are there any allergies that we will need to be aware of?

Are there any special considerations that we need to be aware of?

Is your child taking any medication?

Yes No

If yes please list them, and reason for medication:

Is there anything else that we should be aware of about your child?

Emergency Contact

Emergency Contact First and Last Name

Emergency Contact Phone Number

Emergency Contact Relation to Child

Other Information

By checking this box I understand that photos of my child may be on St. Paul Community Church of Spring social media and website.

Yes

I consent to my child taking part in the activities during Kingdom Kidz Children's Church.

Yes

Description

Please fill out this form for your child to attend Kingdom Kidz children's church!