Children's Ministry

Christmas Play

Children's Registration - God has a plan for you! Jeremiah 29:11

* Indicates required field

Child's Name *

First

Last

Parent/Guardian Name *

First

Last

Grade *

Birthday *

Age *

Address *

Primary Phone *

Emergency Contact *

City, State, ZIP *

Emergency Contact Relationship to Child *

Emergency Contact Phone *

Food Allergies *

Yes No

List *

Medical Concerns *

Yes No

Explain *

Do you give Carr Community Church authorization to seek medical attention? *

Yes No

Family Doctor *

Doctor's Phone *

Name(s) of siblings attending *

Who is authorized to pick up the child? *

Email *

Photo / Filming release *

Church leaders have permission to photograph/film the minor designated above in any manner or form for any lawful purpose associated with church functions.

Overall Release *

By checking here, I give my express consent for the named child to participate to in the activities of “The Carr Community Church” . I release the church and its representatives from any liability in the event of an accident enroute, during, or returning from an activity. I also authorize them to obtain any emergency medical attention that may be required during my child’s attendance.

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Christmas Play

Children's Registration - God has a plan for you! Jeremiah 29:11

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