CUMC KIDS REGISTRATION FORM
Please fill in the form below.
Parent's Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number
*
Alternate Phone Number in case of emergency
*
E-mail
*
example@example.com
Child's Name
First Name
Last Name
Grade
Teacher Name
Child's Name
First Name
Last Name
Grade
Teacher Name
Child's Name
First Name
Last Name
Grade
Teacher Name
Child's Name
First Name
Last Name
Grade
Teacher Name
I give permission for my child or children to be picked up in our church van at Westwood each week for transportation to the Camilla United Methodist Church. By signing this form, I am giving permission for them to ride the van. *I will communicate with the staff each week to confirm they are to pick them up that Wednesday.
Yes
No
If necessary, I give permission for the church staff to seek medical attention for my child or children in the event of an emergency. I understand all efforts will be made to contact the parents first. By signing this form, I give the staff permission to seek medical help if needed.
Yes
No
I would like to help out this year by:
Volunteering in a class regularly
Donating snacks and/or drinks for the kids
Helping with Trunk or Treat in October
Assisting with the Christmas Parade
Making a monetary donation to help with the kids program. The church Venmo is @CamillaUnited-MethodistChurch.
Anything we need to know about your child or children? Any medical concerns?
Thank you so much! We look forward to a faith and fun filled year with our CUMC Kids program! Please let us know if you have any questions!
Signature
*
Submit
Submit
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