KEMC Program Registration 2025-2026

Family Information

This information will be used for contact purposes only.
Parent 1 Name*

First NameLast Name
Parent 2 Name

First NameLast Name
E-mail*
example@example.com
Phone Number*
Home Church (if applicable)
Best method to contact me by :
Registering your child

Please select how many children you are registering below. Each child will have their own registration section. You can register each for multiple programs with one Child Registration form.
Number of children registering:*

Child 1
Child's Name*

First NameLast Name
Child's Birthday*

MonthDayYear
Date
Child's School Grade*
I want to register them for:*

Sunday SchoolLINK (Gr 3-5) on WednesdaysJr. Youth (Gr 6-8) on WednesdaysSr. Youth (Gr 9-12) on Thursdays
Additional Information: To help us care for your child, please list any physical, emotional, or behavioural needs we may need to be aware of.
Snacks are served during our program. Does your child have a food allergy?*

NoYes

Food Allergy Information
What food allergies does your child have?
Do they require an epi-pen

YesNo
Additional Information:

Child 2
Child's Name

First NameLast Name
Child's Birthday

MonthDayYear
Date
Child's School Grade
I want to register them for:

Sunday SchoolLINK (Gr 3-5) on WednesdaysJr. Youth (Gr 6-8) on WednesdaysSr. Youth (Gr 9-12) on Thursdays
Additional Information: To help us care for your child, please list any physical, emotional, or behavioural needs we may need to be aware of.
Snacks are served during our program. Does your child have a food allergy?

NoYes

Food Allergy Information
What food allergies does your child have?
Do they require an epi-pen

YesNo
Additional Information:

Child 3
Child's Name

First NameLast Name
Child's Birthday

MonthDayYear
Date
Child's School Grade
I want to register them for:

Sunday SchoolLINK (Gr 3-5) on WednesdaysJr. Youth (Gr 6-8) on WednesdaysSr. Youth (Gr 9-12) on Thursdays
Additional Information: To help us care for your child, please list any physical, emotional, or behavioural needs we may need to be aware of.
Snacks are served during our program. Does your child have a food allergy?

NoYes

Food Allergy Information
What food allergies does your child have?
Do they require an epi-pen

YesNo
Additional Information:

Child 4
Child's Name

First NameLast Name
Child's Birthday

MonthDayYear
Date
Child's School Grade
I want to register them for:

Sunday SchoolLINK (Gr 3-5) on WednesdaysJr. Youth (Gr 6-8) on WednesdaysSr. Youth (Gr 9-12) on Thursdays
Additional Information: To help us care for your child, please list any physical, emotional, or behavioural needs we may need to be aware of.
Snacks are served during our program. Does your child have a food allergy?

NoYes

Food Allergy Information
What food allergies does your child have?
Do they require an epi-pen

YesNo
Additional Information:

Child 5
Child's Name

First NameLast Name
Child's Birthday

MonthDayYear
Date
Child's School Grade
I want to register them for:

Sunday SchoolLINK (Gr 3-5) on WednesdaysJr. Youth (Gr 6-8) on WednesdaysSr. Youth (Gr 9-12) on Thursdays
Additional Information: To help us care for your child, please list any physical, emotional, or behavioural needs we may need to be aware of.
Snacks are served during our program. Does your child have a food allergy?

NoYes

Food Allergy Information
What food allergies does your child have?
Do they require an epi-pen

YesNo
Additional Information:

Waivers & Release
Photo Waiver

I give permsission for my child's photo or video to be taken and used by Kleefeld EMC for internal purposes, such as slideshows, program highlights, or displays within church programs.
Please select one:

Yes, I give permissionNo, I do not give permission
Waiver Form for Mid-Week Programming

NOTE: Some program events may happen off-site. We will notify you when these events are happening. For LINK off-site activities will not include KEMC transportation, rather a different drop off/ pick up location. Jr/Sr. Youth will have events that will use KEMC transportation.
I, the parent/guardian of the children listed above, give permission for them to participate in mid-week programs with Kleefeld EMC. This includes on-site and off-site activities, and transportation by authorized staff or adult volunteers when required. I understand that leaders will take reasonable care for my children’s safety, but I also recognize there are some inherent risks. I release Kleefeld EMC, its staff, and volunteers from responsibility for accidents, injury, or loss that may occur, except in cases of gross negligence or intentional harm. In case of an emergency, I understand that every effort will be made to contact me. If I cannot be reached, I give permission for leaders to seek medical help as needed.
Parent/Guardian Signature

By signing below, I confirm that I have read and understood this waiver and give my child permission to participate in planned events with Kleefeld EMC.
Signature*

Clear
Date Signed*

MonthDayYear
Date
Should be Empty:

Family Information

Registering your child

Photo Waiver

Waiver Form for Mid-Week Programming

Parent/Guardian Signature