GOD'S CREATIVE SPACE
MEMBERSHIP FORM
Child's Information
Full Name:
Date of Birth:
-
Month
-
Day
Year
Date
Age:
Parent/Guardian Information
Full Name:
Phone Number:
Format: (000) 000-0000.
Email Address:
example@example.com
Emergency Contact (if different from parent)
Name:
Phone Number:
Format: (000) 000-0000.
Medical Information
Does your child have any allergies?
Yes
No
If yes, please explain:
Any medical conditions we should be aware of?
Yes
No
If yes, please explain:
Membership Agreement
Yes, I am signing my daughter up to be a member of God's Creative Space.
By signing below, I understand that:
Membership guarantees my child a spot at all events
My child may be invited to exclusive members-only and sponsored events
Consistent attendance is encouraged as we are preparing for an end-of-year fashion show
Photo/Media Release (optional but recommended)
Yes No I give permission for my child to be photographed and/or recorded during events for promotional use.
Yes
No
Parent/Guardian Signature:
Date:
-
Month
-
Day
Year
Date
Donation (Optional but Appreciated)
I would like to sow a donation to support the program
Amount:
Thank you for being a part of God's Creative Space
Preview PDF
Submit
Should be Empty: