Children's Ministry Registration Form 2023-2024
Please fill out this form and click submit.
Child's Info
Name
*
Gender
*
Please select one option.
Female
Male
Birthdate
*
Grade
*
Please select one option.
Pre-School
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Not in School Yet
Allergies - Does your child have any allergies we should be aware of? Please list them below:
*
Do you have any special instructions or physical, emotional, mental, behavioral concerns/limitations for this child that we should be aware of?
*
I/We, the parents/guardians named above, authorize the ministry staff of Gospel Centre to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the child named above. I/We, named above undertake and agree to indemnify and hold blameless the ministry staff, Gospel Centre, its pastors and board of elders from and against any loss, damage or injury suffered by my child as a result of being part of the activities of Gospel Centre, as well as any medical treatment authorized by the supervising individuals representing the church. This consent and authorization is effective only when participating in or traveling to events of Gospel Centre. By checking one of the boxes below and typing my name below, I am electronically signing this consent form.
*
Please select one option.
Yes
No
Sign your name here
*
Parent / Guardian Info
Name
*
Phone
*
Email
*
This address will receive a confirmation email
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Photo of Child
Upload (8MB)
I give Gospel Centre Church permission to photograph my child/children and/or take video footage. These photographs and/or videos may be used by Gospel Centre Church. Forms of distributing this content may include promotional material, publications, advertisements, website and social media. By checking one of the boxes below, I am electronically signing this consent form.
*
Please select one option.
Yes
No
Sign your name here
*
Submit
Description
Please fill out this form and click submit.
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