NGCC Children’s Ministry Registration

Please complete one form per child so that we have complete information for everyone regarding allergies, doctors, authorized contacts, etc.

NGCC Children's Ministry Registration Form

Mother/Guardian Name * First Last
Mother/Guardian Cell Phone *
Mother/Guardian E-Mail *
Father/Guardian Name * First Last
Father/Guardian Cell Phone *
Father/Guardian E-mail
Child's Name *Please submit one form for each child so that we have complete info for every child taking part in our ministry. First Last
Child's Grade *
Child's Age *
Child's Date of Birth *
Child's School *Provide the name of their school.
Family Home Phone *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Email *
Who is Allowed to Pick up Your Child? *
Please note that a Photo ID is REQUIRED for pickup. List all possible contacts.
Please list any allergies for the registered child. *
Note 'none' if not applicable. Provide any special needs we should consider to make their time with us the best possible. List food and environmental concerns.
Please list all medications your child takes. *
If there are allergies or medications, provide your child's doctor's name and contact phone. *
Secondary/Emergency Contact Name *If we are unable to contact you, who is a secondary contact for us to reach? First Last
Secondary/Emergency Contact Phone *
Secondary/Emergency Contact - Relationship to the Child *Please let us know how this contact is related to/associated with your child.
Agreements *
I agree my child (Name Listed Above) is well and able to participate in the activities of our Children's Ministry. I agree that all of the information I have supplied is accurate to the best of my ability. I recognize it is the responsibility of the parent to bring and pick up my child in a timely fashion. I give permission for my child to be photographed for North Glen Community Church’s website.YesNoOther - See Comments
Comments
Is there anything we should know about your child that can make taking part in our Children's Ministry the best experience possible? Let us know!
Confirmation of Registration *To confirm your agreement with all of the details in this registration, and to confirm that all of the information is correct, please enter your name one more time. This serves as your signature for this online registration. First Last

Verification

Please enter any two digitsExample: 12
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