2023 SWCC Childrens Team Child Update

2023 SWCC Children's Ministry Registration Form
What is this form? This form will update or add your child's information for 2023.

* It is advised to not use autofill on the form *

(You may add up to 5 children, if you have additional children please use the link to complete a another submission for the additional children. )
- Parent/Guardian #1
- First Name*
- Last Name*
- Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip Code
- E-mail*
- Phone Number*
  
  Area CodePhone Number
- What is the last 4 digits of the phone number you will use for Check In?*
- Parent/Guardian #2 (if applicable)
- First Name
- Last Name
- Address as above
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip Code
- E-mail
- Phone Number
  
  Area CodePhone Number
- CHILD "1" INFORMATION
- First Name*
- Last Name*
- Date of Birth*
  
  MonthDayYear
- Gender*
- Current Grade
- Is {firstNamechild1} saved?*
  
  YesNoUncertain
- Has {firstNamechild1} been baptized ?*
  
  YesNo
- Please supply full details of any allergies or dietary conditions experienced by this child.*
- Is there any learning disabilities we should know about?*
- Please supply any details you feel we need to know to greater serve your child.
- CHILD "2" INFORMATION
- First Name
- Last Name
- Date of Birth
  
  MonthDayYear
- Gender
- Current Grade
- Is {firstNamechild2} saved?
  
  YesNoUncertain
- Has {firstNamechild2} been baptized?
  
  YesNo
- Please supply full details of any allergies or dietary conditions experienced by this child
- Is there any learning disabilities we should know about?
- Please supply any details you feel we need to know to greater serve your child.
- CHILD "3" INFORMATION
- First Name
- Last Name
- Date of Birth
  
  MonthDayYear
- Gender
- Current Grade
- Is {firstNamechild3} saved?
  
  YesNoUncertain
- Has {firstNamechild3} been baptized?
  
  YesNo
- Please supply full details of any allergies or dietary conditions experienced by this child
- Is there any learning disabilities we should know about?
- Please supply any details you feel we need to know to greater serve your child.
- CHILD "4" INFORMATION
- First Name
- Last Name
- Date of Birth
  
  MonthDayYear
- Gender
- Current Grade
- Is {firstNamechild4} saved?
  
  YesNoUncertain
- Has {firstNamechild4} been baptized?
  
  YesNo
- Please supply full details of any allergies or dietary conditions experienced by this child
- Is there any learning disabilities we should know about?
- Please supply any details you feel we need to know to greater serve your child.
- CHILD "5" INFORMATION
- First Name
- Last Name
- Date of Birth
  
  DayMonthYear
- Gender
- Current Grade
- Is {firstNamechild5} saved?
  
  YesNoUncertain
- Had {firstNamechild5} been baptized?
  
  YesNo
- Please supply full details of any allergies or dietary conditions experienced by this child
- Is there any learning disabilities we should know about?
- Please supply any details you feel we need to know to greater serve your child.
- Your registration summary:
  
  {c1first} {c1last}
  
  {firstNamechild2} {lastNamechild2}
  
  {firstNamechild3} {lastNamechild3}
  
  {firstNamechild4} {lastNamechild4}
  
  {firstNamechild5} {lastNamechild5}
- My completion of this form signals my willingness to permit my child(ren) to participate fully in the children’s ministry of Still Waters Cowboy Church.*
  
  YesNo
- I give permission in the case of a medical emergency, to the Doctor chosen (either by the Church authorities or other persons supervising or administering the activities), to secure proper treatment for and/or hospitalization, injection, anaesthetic or surgery for my child(ren) as named. I understand that every effort will be made to contact me prior to instituting such procedures.*
  
  YesNo
- I give permission for my child(ren) to be filmed at activities at SWCC and understand that these photos/videos may be displayed and used to promote the group .*
  
  YesNo
- Is there anyone legally restricted from seeing your child(ren)?*
  
  YesNo
- Please provide details of anyone legally restricted from seeing your child(ren):
- Is there any security issues we need to be aware of?*
  
  YesNo
- Please provide details of any security issues we need to be aware of.
- I give permission for these details to be stored in a secure database:*
  
  YesNo
- The Leadership team of the aforementioned group/s will treat the information contained confidentially. This information may be shared with a third party when it concerns medical health or care of individuals listed. If you wish to access this information or have queries in relation to the manner in which we handle your personal information, please do not hesitate to contact us.
- I confirm my agreement to all of these conditions:*
  
  First NameLast Name
- Signature
- Today's date*
  
  DayMonthYear
  Date
- Please verify that you are human*
- Should be Empty:

2023 SWCC Children's Ministry Registration Form

Parent/Guardian #1

Parent/Guardian #2 (if applicable)

CHILD "1" INFORMATION

CHILD "2" INFORMATION

CHILD "3" INFORMATION

CHILD "4" INFORMATION

CHILD "5" INFORMATION