2026-2027 Kids Connection Registration

First Presbyterian Church of Stillwater, MN

2026-27 Kids Connection Registration

For ALL CHILDREN & TEENS at First Presbyterian Church in Stillwater, MN.Use this registration form to register the whole family from birth through 12th grade.
Primary Parent/Guardian

First NameLast Name
Primary Phone Number
Format: (000) 000-0000.
Is this a cell phone number AND you are willing to receive text messages?
Primary Email (will be used to for weekly communication)
example@example.com
Secondary Parent/Guardian

First NameLast Name
Secondary Phone Number
Format: (000) 000-0000.
Is this a cell phone number AND you are willing to receive text messages?
Secondary Email (only include if you want to receive weekly email communication)
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
If child/teen has secondary address that needs to be included in any mailings, please let Director of Children and Youth Ministries know.

In an emergency, we will make every attempt to contact parent/guardian first.

If they cannot be reached, please provide one emergency contact, other than parent/guardian, for us to call.
Emergency Contact

First NameLast Name
Relationship to Child/Teen
Phone Number
Format: (000) 000-0000.

First Child/Teen Name

First NameLast Name
Birth Date

MonthDayYear
Gender
Grade
School
Which ministry opportunities do you want to register for:
If teen is in grades 5-12 and we have PERMISSION to text your teen reminders, what is their cell phone number?
Format: (000) 000-0000.
Any allergies, food restrictions, emotional or learning needs, medical conditions, or information you want to communicate to help us better serve your child? If none, please write "NONE" below.
i.e. peanut allergy, asthma, learning challenges, family stressors/concerns, medical diagnosis, transportation issues, etc.
For children six and under, parent or guardian is required to pick up children from their room. Older children and teens are dismissed from their rooms. Are there any unauthorized person(s) to PICK UP child/teen we should be aware of?
List any specific persons who are NOT AUTHORIZED to pickup your child(ren)/youth
Do you have another child/teen to register?

Second Child/Teen Name

First NameLast Name
Birth Date

MonthDayYear
Gender
Grade
School
Which ministry opportunities do you want to register for:
If teen is in grades 5-12 and we have PERMISSION to text your teen reminders, what is their cell phone number?
Format: (000) 000-0000.
Any allergies, food restrictions, emotional or learning needs, medical conditions, or information you want to communicate to help us better serve your child? If none, please write "NONE" below.
i.e. peanut allergy, asthma, learning challenges, family stressors/concerns, medical diagnosis, transportation issues, etc.
For children six and under, parent or guardian is required to pick up children from their room. Older children and teens are dismissed from their rooms. Are there any unauthorized person(s) to PICK UP child/teen we should be aware of?
List any specific persons who are NOT AUTHORIZED to pickup your child(ren)/youth
Do you have another child/teen to register?

Third Child/Teen Name

First NameLast Name
Birth Date

MonthDayYear
Gender
Grade
School
Which ministry opportunities do you want to register for:
If teen is in grades 5-12 and we have PERMISSION to text your teen reminders, what is their cell phone number?
Format: (000) 000-0000.
Any allergies, food restrictions, emotional or learning needs, medical conditions, or information you want to communicate to help us better serve your child? If none, please write "NONE" below.
i.e. peanut allergy, asthma, learning challenges, family stressors/concerns, medical diagnosis, transportation issues, etc.
For children six and under, parent or guardian is required to pick up children from their room. Older children and teens are dismissed from their rooms. Are there any unauthorized person(s) to PICK UP child/teen we should be aware of?
List any specific persons who are NOT AUTHORIZED to pickup your child(ren)/youth
Do you have another child/teen to register?

Fourth Child/Teen Name

First NameLast Name
Birth Date

MonthDayYear
Gender
Grade
School
Which ministry opportunities do you want to register for:
If teen is in grades 5-12 and we have PERMISSION to text your teen reminders, what is their cell phone number?
Format: (000) 000-0000.
Any allergies, food restrictions, emotional or learning needs, medical conditions, or information you want to communicate to help us better serve your child? If none, please write "NONE" below.
i.e. peanut allergy, asthma, learning challenges, family stressors/concerns, medical diagnosis, transportation issues, etc.
For children six and under, parent or guardian is required to pick up children from their room. Older children and teens are dismissed from their rooms. Are there any unauthorized person(s) to PICK UP child/teen we should be aware of?
List any specific persons who are NOT AUTHORIZED to pickup your child(ren)/youth

Permissions & Authorizations

Please check each box acknowledging and giving permission effective September 1, 2026 through August 31, 2027.
PARTICIPATION: I give permission for my child / teen to participate in programs and events at and with First Presbyterian Church of Stillwater.
MEDICAL RELEASE: In the event that my child / teen requires emergency treatment, I grant permission to First Presbyterian Church of Stillwater personnel to seek and perform the necessary emergency medical treatment for my child(ren) on my behalf. I understand they will make every reasonable effort to contact me or the emergency contact I provided in this form.
WAIVER OF LIABILITY: I agree to hold First Presbyterian Church of Stillwater and any staff, members and volunteers free and waive any claims for payment for accident, injury, disability, or damages to the person or property of the aforementioned child arising out of, related to or connected with his/her/their participation in any Kids Connection or church activity.
PHOTOGRAPHY / MEDIA RELEASE: I authorize First Presbyterian Church of Stillwater to use my child’s image in communications. Your child’s image may be used in a variety of communications: Connection newsletter, FPC’s weekly email, Sunday bulletin, and FPC’s website and social media and within the church building on bulletin boards and in presentations. There may be times that your child’s first name will be connected to these images.
Today's Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature
Printed Name

First NameLast Name
Should be Empty:

2026-27 Kids Connection Registration

Permissions & Authorizations