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PARTNERSHIP
MENTORSHIP
EVENTS
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ONLINE STORE
Children's Ministry Registration Form
Note: If you have any questions or require additional information, please contact the Children's Ministry in-person, via telephone or
email
at children@gethsemaneministry.org.
*
Indicates required field
Name of Child
*
First
Last
Gender
*
Male
Female
Grade
*
Please type "NA" if your child is not currently attending school.
School Name
*
Please type "NA" if your child is not currently attending school.
City
*
Please type "NA" if your child is not currently attending school.
State
*
Please type "NA" if your child is not currently attending school.
Age
*
Date of Birth (MM/DD/YYYY)
*
Home Address
*
City
*
State
*
Zip Code
*
Child's Home Phone Number
*
T-Shirt Size
*
Youth Extra Small
Youth Small
Youth Medium
Youth Large
Youth Extra Large
Parent/Guardian - Contact Information
Parent/Guardian #1
*
First
Last
Choose One
*
Mr.
Mrs.
Ms.
Other
Home Address
*
City
*
State
*
Zip Code
*
Email
*
Home Phone Number
*
Mobile Phone Number
*
Parent/Guardian #2
*
First
Last
Choose One
*
Mr.
Mrs.
Ms.
Other
Home Address
*
City
*
State
*
Zip Code
*
Email
*
Home Phone Number
*
Mobile Phone Number
*
Additional Information
Is your child allergic to any type of food or medication?
*
Yes
No
If yes, explain:
*
Does your child require a special diet?
*
Yes
No
If yes, explain:
*
Does your child have any needs that require staff attention during Sunday School?
*
Yes
No
If yes, explain:
*
Photo Release
I hereby give permission for my child to be photographed during
GMI Children's Ministry
activities. I understand the photos will be used to keep a journal of activities, to share during power point presentations and/or reports to our donors and for promotional purposes including flyers, brochures, newspaper and on the internet. I understand that although my child’s photograph may be used for advertising, his or her identity will not be disclosed, I do not expect compensation and that all photos are the property of Gethsemane Ministry, Inc.
Name of Parent/Guardian Authorizing Photo Release
*
Transportation Release
I hereby give permission for the transportation
of my child for official
GMI Children's Ministry
activities by modes of transportation agreed to by Gethsemane Ministry, Inc.
Name of Parent/Guardian Authorizing Transportation Release
*
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