Calvary Bible Church

Kids Church Registration and Consent 2024-25

• • In the case of custody agreements, please include the proper form authorizing parental contacts
     
  • Child #1*
    First Name

    Last Name
  • Birthdate *
    MM

    DD

    YYYY
  • Address
    Street Address

    Address Line 2

    City

    Province / State / Region

    Postal Code / Zip

    Antigua and BarbudaBahamasBarbadosBelizeCanadaCosta RicaCubaDominicaDominican RepublicEl SalvadorGrenadaGuatemalaHaitiHondurasJamaicaMexicoNicaraguaPanamaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesTrinidad and TobagoUnited StatesArgentinaBoliviaBrazilChileColumbiaEcuadorGuyanaParaguayPeruSurinameUruguayVenezuelaAlbaniaAndorraArmeniaAustriaAzerbaijanBelarusBelgiumBosnia and HerzegovinaBulgariaCroatiaCyprusCzech RepublicDenmarkEstoniaFinlandFranceGeorgiaGermanyGreeceHungaryIcelandIrelandItalyLatviaLiechtensteinLithuaniaLuxembourgMacedoniaMaltaMoldovaMonacoMontenegroNetherlandsNorwayPolandPortugalRomaniaSan MarinoSerbiaSlovakiaSloveniaSpainSwedenSwitzerlandUkraineUnited KingdomVatican CityAfghanistanBahrainBangladeshBhutanBrunei DarussalamMyanmarCambodiaChinaEast TimorIndiaIndonesiaIranIraqIsraelJapanJordanKazakhstanNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLebanonMalaysiaMaldivesMongoliaNepalOmanPakistanPhilippinesQatarRussiaSaudi ArabiaSingaporeSri LankaSyriaTaiwanTajikistanThailandTurkeyTurkmenistanUnited Arab EmiratesUzbekistanVietnamYemenAustraliaFijiKiribatiMarshall IslandsMicronesiaNauruNew ZealandPalauPapua New GuineaSamoaSolomon IslandsTongaTuvaluVanuatuAlgeriaAngolaBeninBotswanaBurkina FasoBurundiCameroonCape VerdeCentral African RepublicChadComorosCongoDjiboutiEgyptEquatorial GuineaEritreaEthiopiaGabonGambiaGhanaGuineaGuinea-BissauCôte d\'IvoireKenyaLesothoLiberiaLibyaMadagascarMalawiMaliMauritaniaMauritiusMoroccoMozambiqueNamibiaNigerNigeriaRwandaSao Tome and PrincipeSenegalSeychellesSierra LeoneSomaliaSouth AfricaSudanSwazilandTanzaniaTogoTunisiaUgandaZambiaZimbabwe

    Country
  • Phone Number
     

    (###)

    -

    ###

    -

    ####
  • Parent/Guardian Phone #
     

    (###)

    -

    ###

    -

    ####
  • Your E-mail
     
  • Grade for the 2024-25 School Year
  • Special Notes
    Please indicate any allergies, learning or physical disabilities, or other information which we should be aware of.
• Self Sign in/Out Authorization

  Parents/guardians may give older children (Grades 4-6) permission to sign in/out themselves and siblings in Grades 1-3.
  • Permission to leave Kid's Church supervision after signing out (Applicable to Grades 4-6)
    Yes

    No
  • Permission for above child to sign out siblings and take them from Kids Church supervision (applicable for siblings in grades 1-3 only)
    Yes

    No
  • Names of Siblings who may be signed out
  • Register Additional Children
    Yes

    No
  • Child #2
    First Name

    Last Name
  • Birthdate
    MM

    DD

    YYYY
  • Grade for the 2024-25 School Year
  • Special Notes
    Please indicate any allergies, learning or physical disabilities, or other information which we should be aware of.
• Self Sign in/Out Authorization

  Parents/guardians may give older children (Grades 4-6) permission to sign in/out themselves and siblings in Grades 1-3.
  • Permission to leave Kid's Church supervision after signing out (Applicable to Grades 4-6)
    Yes

    No
  • Permission for above child to sign out siblings and take them from Kids Church supervision (applicable for siblings in grades 1-3 only)
    Yes

    No
  • Names of Siblings who may be signed out
  • Child #3
    First Name

    Last Name
  • Birthdate
    MM

    DD

    YYYY
  • Grade for the 2024-25 School Year
  • Special Notes
    Please indicate any allergies, learning or physical disabilities, or other information which we should be aware of.
• Self Sign in/Out Authorization

  Parents/guardians may give older children (Grades 4-6) permission to sign in/out themselves and siblings in Grades 1-3.
  • Permission to leave Kid's Church supervision after signing out (Applicable to Grades 4-6)
    Yes

    No
  • Permission for above child to sign out siblings and take them from Kids Church supervision (applicable for siblings in grades 1-3 only)
    Yes

    No
  • Names of Siblings who may be signed out
  • Child #4
    First Name

    Last Name
  • Birthdate
    MM

    DD

    YYYY
  • Grade for the 2024-25 School Year
  • Special Notes
    Please indicate any allergies, learning or physical disabilities, or other information which we should be aware of.
• Self Sign in/Out Authorization

  Parents/guardians may give older children (Grades 4-6) permission to sign in/out themselves and siblings in Grades 1-3.
  • Permission to leave Kid's Church supervision after signing out (Applicable to Grades 4-6)
    Yes

    No
  • Permission for above child to sign out siblings and take them from Kids Church supervision (applicable for siblings in grades 1-3 only)
    Yes

    No
  • Names of Siblings who may be signed out
• Liability Release
  • I/we, named below, undertake and agree to indemnify and hold harmless Program Personnel, Calvary Bible Church, and its Leaders from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Calvary Bible Church, as well as of any medical treatment authorized by the supervising individuals representing Calvary Bible Church. This consent and authorization is effective only when participating in or traveling to events sponsored by Calvary Bible Church.
    YES I ackowledge the above statement
  • In lieu of your signature, please enter your name
• Medical Release
  • I/we, the parents or guardians named below authorize the Ministry Lead of Calvary Bible Church's programs to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participan(s) named above.
    YES, I grant permission as stated above for my child regarding medical care
  • In lieu of your signature, please enter your name
• Photo Release
  • Photographs are sometimes taken of Kid's Church ministry activities for future promotional purposes, which may include, but are not limited to , in-house presentations, church web site and newsletters. Please check below if you grant Calvary Bible Church permission to use your child's photographs.
    YES, I grant permission for use of photographs of my child as stated above.

    NO, I do NOT authorize use of photographs of my child
  • In lieu of your signature, please enter your name
• 
  Submit