Youth and Children's Registration 2025-2026

Name of participant

Date of Birth

Address

Student Email (optional)

Student Phone (optional)

Activities this child will particpate in: Nursery Sunday school Wednesday evening club S.O.U.L. Singers

This child may leave on his/her own after an activity has concluded.

Yes No

This child has permission to be transported to and from off-campus activities as arranged by activity leaders.

Yes No Only with an adult driver. May drive him/herself.

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

Allergies and medical conditions. Please include treatment instructions for any potential emergency situations (i.e. needing an inhaler, epi-pen, seizure procedure, etc.)

Sensory or learning concerns. Please indicate anything (lighting, sound, temperature, etc.) that triggers anxiety or emotional distress as well as any known tips for helping your child thrive.

I acknowledge that I am able to access the KMC Children's Ministries Statement of Policies found at kidronmennonite.com at any time. Please initial:

General Liability Release for all KMC sponsored activities Acknowledgment of Risk: I understand that any activity involves certain risks. I have carefully considered the risks involved, 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.

Yes, I give permission for my child's image to be used online. No, I do not give permission for my child's image to appear online

Youth and Children's Registration 2025-2026

Description

Please Fix the Following