Children Registration

(for AWANA, Sunday School and Children’s Church)

2017-2018 School Year
 
 

    By signing my name below, I do hereby authorize the Woodstock Evangelical Covenant Church to seek emergency medical care for my child(ren) in the event of injury, accident or illness

    Parent's Name (required)

    Street Address (required)

    City/State/Zip Code(required)

    Phone Number (required)

    Parent's Email (required)

    Emergency Contact Name 1 (required)

    Emergency Contact Phone 1 (required)

    Emergency Contact Name 2 (required)

    Emergency Contact Phone 2 (required)

    Insurance provider and number(required)

    May we have your permission to photograph your child(ren)? (required)
    YesNo

    Child (1) Name

    Child (1) Age

    Child (1) Grade

    Child (1) Birth Date

    Medical/Health/Allergy Concerns (1)

    Child (2) Name

    Child (2) Age

    Child (2) Grade

    Child (2) Birth Date

    Medical/Health/Allergy Concerns (2)

    Child (3) Name

    Child (3) Age

    Child (3) Grade

    Child (3) Birth Date

    Medical/Health/Allergy Concerns (3)

    I give permission for my child(ren) to be picked up by: