Youth Group Registration

Youth Group Registration

Parent/Guardians
Parent 1 Name

First NameLast Name
Parent 1 Email
example@example.com
Parent 2 Name

First NameLast Name
Parent 2 Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number 1

Area CodePhone Number
Phone Number 2

Area CodePhone Number
Photo and Video Release

I am aware that photographs or video may be taken of FCC Kids’ participants on Wednesday evenings and during various events/activities. I give First Church of Christ and its representatives permission to use photographs or videos that include my child in any and all media products for promotion, art, advertising, editorial or other purposes.
Do you agree or disagree with above photo release.
Signature of Parent or Legal Guardian.
Children
Child's Name:

First NameLast Name
Gender:
Date of Birth:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age:
Allergies/Restrictions:
Grade:
T-Shirt Size:

Children