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Child Registration Form
Parent/Guardian's First Name
Parent/Guardian's Last Name
Mailing Address
Email
Phone
Child's First and Last Name
Chid's Date of Birth
Current Grade in School
Choose an option
Please list any allergies below.
Please list any dietary restrictions below.
Please list any medical or behavioral considerations for your child(ren) below.
My permission is granted for Glory Church and its staff and volunteers to obtain necessary medical attention in case of sickness or injury to my child.
I understand that my child may be photographed or videotaped while participating in the activities and events sponsored by Glory Church, and give my permission and consent to allow these photographs or videotapes to be used in promotional materials.
Submit
Thank you!
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