Form
UNITY BAPTIST CHURCH CHILDRENS MINISTRY REGISTRATION FORM
COMPLETE ONE PER CHILD
CHILD'S NAME
First Name
Last Name
PRIMARY PARENT NAME
First Name
Last Name
PRIMARY PARENT PHONE NUMBER
Please enter a valid phone number.
PRIMARY PARENT EMAIL ADDRESS
example@example.com
ADDITIONAL AUTHORIZED ADULT TO PICK UP YOUR CHILD
First Name
Last Name
ADDITIONAL AUTHORIZED ADULT PHONE NUMBER
Please enter a valid phone number.
ADDITIONAL AUTHORIZED ADULT EMAIL ADDRESS
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
CHILDS DATE OF BIRTH
-
Month
-
Day
Year
Date
CHILDS GRADE IN SCHOOL
Please Select
TODDLER
PRE-KINDERGARTEN (PRE-SCHOOL)
KINDERGARTEN
FIRST GRADE
SECOND GRADE
THIRD GRADE
FOURTH GRADE
FIFTH GRADE
SIXTH GRADE
SEVENTH GRADE
EIGHTH GRADE
NINTH GRADE (FRESHMAN)
TENTH GRADE (SOPHMORE)
ELEVENTH GRADE (JUNIOR)
TWELFTH GRADE (SENIOR)
DO WE HAVE PERMISSION TO POST PICTURES OF YOUR CHILD ON SOCIAL MEDIA?
YES
NO
WHICH PROGRAM WILL YOUR CHILD BE ATTENDING? (MARK ALL THAT APPLY)
SUNDAY SCHOOL
KIDS OWN WORSHIP (KOW)
CLUB 185 KIDS
UNITED YOUTH
DOES YOUR CHILD HAVE ANY ALLERGIES?
ANY SPECIAL NEEDS YOU WOULD LIKE TO SHARE WITH THE CHURCH REGARDING YOUR CHILD? (THIS INFORMATION WILL BE KEPT CONFIDENTIAL AND WILL ONLY BE SEEN BY NECESSARY STAFF MEMBERS.)
CHURCH BUS PERMISSION
IF YOUR CHILD WILL BE RIDING THE CHURCH VAN/BUS TO ANY OF THE ABOVE LISTED PROGRAMS PLEASE MESSAGE OUR DRIVERS THROUGH THE "TEAMREACH" APP. TEAMREACH APP GROUP CODE: UnityClub185
WILL YOUR CHILD BE RIDING THE CHURCH BUS?
YES
NO
I HEREBY GIVE PERMISSION FOR MY CHILD, LISTED ABOVE, TO RIDE THE UNITY BAPTIST CHURCH BUS TO ATTEND CHURCH ACTIVITIES. I UNDERSTAND THAT MY CHILD WILL BE UNDER ADULT SUPERVISION. I FURTHER UNDERSTAND THAT IN SIGNING THIS REGISTRATION, I RELEASE UNITY BAPTIST CHURCH, STAFF, AND VOLUNTEERS FROM ANY LIABILTY PAST, PRESENT, OR FUTURE. I AUTHORIZE THE STAFF OR DESIGNATED MEDICAL PROFESSIONALS TO ADMINISTER EMERGENCY MEDICAL ASSISTANCE IF I CANNOT BE CONTACTED.
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