The Ship Kids Registration

"THE SHIP KIDS" Registration

Complete A Form For Each Child
Parent/Guardian Information
Name:*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
Phone Number*

Area CodePhone Number
Child Information:
Child's Name*

First NameLast Name
Current Age*
Gender*
Birth Date*

MonthDayYear
Child's Address*

Same as aboveDifferent
Child's Address if Different from Above

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
List allergy concerns: (If any)
List medical concerns: (If any)
Emergency Phone # if Parent can not be reached:*
Emergency Contact Relationship:*
Shirt Size
Child's T-Shirt Size
Photo Consent:

Photos may be taken of the children during our SHIP KIDS activities and may be used in our church Social Media Posts.. Please check one of the the Photo Consent Boxes below for your child.
Photo Consent:

Yes, Photo Consent is GrantedNo, Photo Consent is Not Granted
Need A Ride to Church?:

Yes, My Child Needs A Ride To ChurchNo, My Child Does Not Need A Ride To Church.
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"THE SHIP KIDS" Registration