New Life Christian Center | Christian Church in St. George, Utah

Registration for Kingdom Kids Easter & 4 Year Anniversary Celebration

Child's Full Name

Preferred name / Nickname

Date of Birth

Birthdate

Age & Grade

Gender

Parent / Guardian Contact

First Name

Last Name

Relationship to Child

Primary Phone Number

Secondary Phone Number

Address

Apartment, suite, etc.

City

State

Postal / Zip Code

Emergency Contact Name

Phone Number

Relationship to Child

Allergies / Medical Conditions / Chronic Illnesses

How did you hear about us?

I would like to learn more about (check all that apply):

Baptism

Children's Ministry Events

Growing Spiritually

Anything else you'd like to share?

I grant permission for my child to be photographed or filmed during church activities and for those images/videos to be used by the ministry for promotional, educational, and online purposes.

Yes

By typing my name below, I provide my electronic signature and consent to the statements on this form.

Electronic Signature (Please Type Name)

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Registration for Kingdom Kids Easter & 4 Year Anniversary Celebration

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