GRACE Kids and Nursery Registration

GRACE Kids and Nursery Registration

Nursery and grade specific programming is offered for children 6 weeks old - 5th grade at 8:30, 9:45, & 11:00 on Sunday mornings.
Guardian #1 Name *

Prefix First Name Last Name
Are you a:

Member Regular Attendee Visitor
Please check what service you will be attending: *

8:30 Modern 9:45 Classic 11:00 Modern
Guardian #2 Name

Prefix First Name Last Name
Are you a:

Member Regular Attendee Visitor
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Address of Parent if not living with child

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Guardian #1 Best Contact Number *

Area Code Phone Number
Guardian #2 Best Contact Number

Area Code Phone Number
Primary E-mail *
I give my child(ren) permission to participate in all Sunday School or Nursery activities and to receive first aid treatment, if necessary.

My child’s image may appear in print or online promoting church activities, including the church’s website, promotional brochures, worship presentations, social media, and the church’s YouTube channel. I understand that my child’s name will not be used in any of these circumstances. This permission form will be kept on file in the church office. If I would like to withdraw my permission, I may do so at any time.
*

I agree to the above releases
Name of 1st Child: *

First Name Last Name
Birthdate: *

Month Day Year
Date
Age: *
Gender: *

Male Female
Grade in 2022-2023 *
School: *
Allergies, Medical Concerns, or Special Needs: *
Name of 2nd Child:

First Name Last Name
Birthdate:

Month Day Year
Date
Age:
Gender:

Male Female
Grade in 2022-2023
School:
Allergies, Medical Concerns, or Special Needs: *
Name of 3rd Child:

First Name Last Name
Birthdate:

Month Day Year
Date
Age:
Gender:

Male Female
Grade in 2022-2023
School:
Allergies, Medical Concerns, or Special Needs: *
Name of 4th Child:

First Name Last Name
Birthdate:

Month Day Year
Date
Age:
Gender:

Male Female
Grade in 2022-2023
School:
Allergies, Medical Concerns, or Special Needs: *
AUTHORIZED PICK-UP INFORMATION

GRACE Kids will be using a secure child check-in system for all Sunday School classes and Nursery. Please list the names of individuals (other than guardians listed above) that are authorized to pick up your child(ren). In the event that a parent security tag is lost, children can only be released to parents/guardians or individuals listed below, after showing proper ID.
Name #1

First Name Last Name
Relationship
Phone Number

Area Code Phone Number
Name #2

First Name Last Name
Relationship
Phone Number

Area Code Phone Number
Name #3

First Name Last Name
Relationship
Phone Number

Area Code Phone Number
RED FLAG: This person is NOT authorized to pick up my child(ren):
Name

First Name Last Name
Should be Empty: