Caravan Registration Form

CARAVAN Registration Form

Kingman Church of the Nazarene
Free Scouting Club
Please fill out form and click submit
Students Name

First NameLast Name
Birthday

MonthDayYear
Date
Age
Grade
Guardians

First NameLast Name
Guardians

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
If I can't be reached in an emergency, contact:
Allergies or special needs:
Anything else you would like us to know:
This information is very important to the care of your child while they are at church. We thank you for your cooperation in getting this form back to us.
Occasionally, the newspaper does a story about us and includes a photo or we may use pictures on our church website, or teachers may want to share classrooms pictures on their personal sites.

We need your permission to use photos with your child in them.

My signature below gives permission to the Kingman Church of the Nazarene to publish photographs with my child in them.
Signature
Should be Empty:

CARAVAN Registration Form