Youth / Child Information Form 2023

Child/ Youth Registration Form

Child's Name

DOB

Address

City

State

Zip

School Attending Fall 2023

Grade in Fall 2023

Allergies

Information that would be for a helpful for us to know about your child

Parent Information:

Fathers Name

Phone Number

Fathers Email

example@example.com

Mothers Name

Phone Number

Mothers Email

example@example.com

When attending worship, where do you typically sit

Best way to reach you if you are not in worship attendance

Additional Emergency Contacts / People authorized to pick up your child

Name

Relationship / Phone #

Name

Relationship / Phone #

OCC Communications shares photographs of kids and youth in various Family Ministry Programs and Events in church newsletters, websites, or other social media platforms as a means of promoting activities happening at the church. Please provide your authorization below should any of these photographs incude your child.

Type a question

I authorizeI do not authorize

Signature

Clear

Date