K-5th Grade Registration

1
Parent/Guardian 1* This field is required.
First Name
Last Name
2
Parent/Guardian 2(Optional)
First Name
Last Name
3
Email* This field is required.
4
Phone Number* This field is required.
Area Code
Phone Number
5
Alternate Phone Number(Optional)
Area Code
Phone Number
6
Address* This field is required.
Street Address
Street Address Line 2
City
Please Select
MI
State
Zip Code
Please Select
Please Select
Afghanistan
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Algeria
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Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
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Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
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Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
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Paraguay
Peru
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Pitcairn Islands
Poland
Portugal
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Qatar
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Rwanda
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Isle of Man
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Zambia
Zimbabwe
Other
Country
7
Are you a Fellowship:* This field is required.
Member
Regular Attendee
Visitor
8
What is your home church?
9
Emergency Name* This field is required.
First Name
Last Name
10
Emergency Phone Number* This field is required.
Area Code
Phone Number
11
Emergency Relationship* This field is required.
12
Child's Name* This field is required.
First Name
Last Name
13
Gender* This field is required.
Male
Female
14
Grade (Fall 2026)* This field is required.Pre-K/Kindergartners need to be 5 years old by December 1
Pre-K/Kind. (5/yo by Dec 1)
1st
2nd
3rd
4th
5th
15
School* This field is required.
16
Optional: Place me in a class with(must be in the same grade)
First Name
Last Name
17
Allergies/Special Instructions* This field is required.
18
Security Tag

For Security Purposes, all children will receive a color-coded ID tag.

RED Tag - Mandatory for Kindergarten and 1st Grade. The child will be held with their class until pickup.

GREEN Tag - The child will be released from classes on their own and understand that after their release they are no longer the responsibility of Fellowship Reformed Church, its staff, or its volunteers.
19
Security Tag* This field is required.
RED Tag - Mandatory for Kindergarten and 1st Grade
GREEN Tag
20
Would you like to add a second child?* This field is required.
YESNO
21
Child's Name* This field is required.
First Name
Last Name
22
Gender* This field is required.
Male
Female
23
Grade (Fall 2026)* This field is required.Pre-K/Kindergartners need to be 5 years old by December 1
Pre-K/Kind. (5/yo by Dec 1)
1st
2nd
3rd
4th
5th
24
School* This field is required.
25
Optional: Place me in a class with(must be in the same grade)
First Name
Last Name
26
Allergies/Special Instructions* This field is required.
27
Security Tag

For Security Purposes, all children will receive a color-coded ID tag.

RED Tag - Mandatory for Kindergarten and 1st Grade. The child will be held with their class until pickup.

GREEN Tag - The child will be released from classes on their own and understand that after their release they are no longer the responsibility of Fellowship Reformed Church, its staff, or its volunteers.
28
Security Tag* This field is required.
RED Tag - Mandatory for Kindergarten and 1st Grade
GREEN Tag
29
Would you like to add a third child?* This field is required.
YESNO
30
Child's Name* This field is required.
First Name
Last Name
31
Gender* This field is required.
Male
Female
32
Grade (Fall 2026)* This field is required.Pre-K/Kindergartners need to be 5 years old by December 1
Pre-K/Kind. (5/yo by Dec 1)
1st
2nd
3rd
4th
5th
33
School* This field is required.
34
Optional: Place me in a class with(must be in the same grade)
First Name
Last Name
35
Allergies/Special Instructions* This field is required.
36
Security Tag

For Security Purposes, all children will receive a color-coded ID tag.

RED Tag - Mandatory for Kindergarten and 1st Grade. The child will be held with their class until pickup.

GREEN Tag - The child will be released from classes on their own and understand that after their release they are no longer the responsibility of Fellowship Reformed Church, its staff, or its volunteers.
37
Security Tag* This field is required.
RED Tag - Mandatory for Kindergarten and 1st Grade
GREEN Tag
38
Would you like to add a fourth child?* This field is required.
YESNO
39
Child's Name* This field is required.
First Name
Last Name
40
Gender* This field is required.
Male
Female
41
Grade (Fall 2026)* This field is required.Pre-K/Kindergartners need to be 5 years old by December 1
Pre-K/Kind. (5/yo by Dec 1)
1st
2nd
3rd
4th
5th
42
School* This field is required.
43
Optional: Place me in a class with(must be in the same grade)
First Name
Last Name
44
Allergies/Special Instructions* This field is required.
45
Security Tag

For Security Purposes, all children will receive a color-coded ID tag.

RED Tag - Mandatory for Kindergarten and 1st Grade. The child will be held with their class until pickup.

GREEN Tag - The child will be released from classes on their own and understand that after their release they are no longer the responsibility of Fellowship Reformed Church, its staff, or its volunteers.
46
Security Tag* This field is required.
RED Tag - Mandatory for Kindergarten and 1st Grade
GREEN Tag
47
Doctor's Name* This field is required.
First Name
Last Name
48
Doctor's Phone* This field is required.
Area Code
Phone Number
49
Preferred Hospital* This field is required.
50
Terms & Conditions

1. Release of Liability - I, for myself, my minor child(ren) and for my child(ren)’s other parent and/or guardian, hereby release, waive, discharge, and covenant not to sue Fellowship Reformed Church of Hudsonville and its officers, directors, employees, agents, volunteers, heirs and assigns (together "FRC") of and from all liability, loss, claims, demands, possible causes of action, court costs, attorneys' fees and other expenses arising from any claim or lawsuit of any kind that may otherwise accrue from any loss, damage or injury to my child(ren)’s person or property in any way resulting from or connected with my child(ren)’s participation in any ministry activity at FRC, including, without limitation, the failure of anyone to enforce rules and/or regulations, failure to make inspections, or the negligence of other persons. If any claim or lawsuit is brought, this release shall be enforced under Michigan law. Any claim or lawsuit must be brought within 180 days from the date of the alleged loss, damage or injury.

2. Photo Release - I give permission for photo and video of my child(ren), which may be taken during any ministry activity, to be used for publication purposes and/or to appear on the church website, social media, or other in-house publicity.

3. Photo Sensitivity - I understand that the VBS opening/closing events may contain certain light patterns and movements which can affect people who are susceptible to photo sensitivities.

4. Consent to Medical Treatment - In the event my child becomes ill or injured, I give my permission for a representative of FRC to take whatever steps are reasonably necessary to render emergency first aid to my child. In the event I cannot be reached, I hereby grant permission to the physicians selected by FRC to hospitalize, secure treatment for and/or order injection, anesthesia or surgery for my child(ren).
51
Electronic Signature* This field is required.
First Name
Last Name
52
Date Signed* This field is required.
Date
Month
Day
Year
53
Please verify that you are human* This field is required.
Should be Empty: