GTI Kid Zone Emergency Contact

GTI Kid Zone Emergency Contact Form

Please provide emergency contact details for your child
Child's Full Name

First NameLast Name
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address
example@example.com
Alternate Emergency Contact Name

First NameLast Name
Relationship to Childhood
Alternate Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Dietary Restrictions

Please let us know of any dietary needs or restrictions.
Does your child have any dietary restrictions?, Please select below
Dietary Restrictions

Other
Does your child have any food allergies? If so, please list below
Is your child allergic to animals?
General Liability Release & Activity Consent"I give permission for my child to participate iin Glad Tidings International children's/youth ministry activities, events, and programs, both on and off church property. In consideration of my child being allowed to participate, I release and hold harmless Glad Tidings International COGIC its staff, leaders, and volunteers from any and all liability for ordinary negligence arising out of or connected to these activities."
Signature
Photo/Media Consent. Yes, I give permission for photographs or videos of my child to be taken during church activities and used for church promotional materials, newsletters, or social media pages. No, I do not give permission for my child's image to be published.
Should be Empty:

GTI Kid Zone Emergency Contact Form

Dietary Restrictions