Kids Movie Time
Saturday, February 28, 2026 2:00-4:00pm Kingsway House Basement
Children's Information
Child's Name
First Name
Last Name
Child's Age
Does your child have any allergies, chronic illness, or medical conditions? If yes, please describe.
Child's Name
First Name
Last Name
Child's Age
Does your child have any allergies, or medical conditions? If yes, please describe.
Child's Name
First Name
Last Name
Child's Age
Does your child have any allergies, or medical conditions? If yes, please describe.
Child's Name
First Name
Last Name
Child's Age
Does your child have any allergies, or medical conditions? If yes, please describe.
Parent/Guardian Information
Name
First Name
Last Name
E-mail
example@example.com
Permission to Take Photographs or videos. I you agree, please sign below by typing your name.
Liability Waiver: Please type your name if you agree to release Kingsway Baptist Church from liability.
Emergency Contact
Name
First Name
Last Name
Cell Number
Format: (000) 000-0000.
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