Youth and Children's Registration 2024-25
Please fill out this form and click submit.
Name of participant
*
Date of Birth
*
Grade in school on 9/1/24
*
Please select one option.
preK
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Select Option
preK
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Address
*
--
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
Email
*
Student Email (optional)
Student Phone (optional)
Activities this child will particpate in:
Please select all that apply.
nursery
Sunday school
Wednesday evening club
Parent/Guardian 1 Name, cell phone number and location during Sunday school
*
Parent/Guardian 2 Name, cell phone number and location during Sunday school
Emergency Contact name, relationship, phone number
*
Facts concerning your child's medical history, (including allergies, medications being taken, physical or mental/emotional concerns) that may impact participation.
*
I have read and understand the KMC Children's Ministries Statement of Policies found at kidronmennonite.com.Please initial:
*
General Liability Release for all KMC sponsored activities Acknowledgment of Risk: While the above activities can be fun, I understand that they involve certain risks. I have carefully considered the risks involved, including the risk of contracting and spreading Covid-19, and consent to my child’s participation in the above activities. I understand that participation in the above activities is entirely voluntary and participants, including my child, must abide by applicable rules and standards of conduct. I understand that the above activities may require my child or children to be transported by Kidron Mennonite Church’s staff or volunteers.Please initial:
*
Release from Liability: I release Kidron Mennonite Church, its staff, its volunteers, and other persons or organizations associated with the above activities from all claims arising out of my child’s participation in the above activities or transportation incident to such participation. Indemnification: Further, I agree to indemnify Kidron Mennonite Church, its staff, its volunteers, and any other persons or organizations associated with the above activities against any claims for injury, death, or property damage brought by or on behalf of my child as a result of participation in the above activities. * Please initial
*
I hereby grant permission for images and video of my child to be used on our website, in printed materials and in our livestreaming of services. Please initial:
*
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