Kid's Ministry Information/Registration Form

Sunday Morning Kid's Ministry Registration Form (School Year 2026-2027)

Information received is confidential and is being gathered for the purposes of serving your child while they are at Sunday morning kid's ministry programs with Huron Chapel. Any medical information collected here serves to authorize Huron Chapel, its Staff and Volunteers, to obtain medical assistance in emergencies. This registration form is for all activities happening within regular Sunday morning kid's ministry events.

Child's First Name *

Child's Last Name *

Date of Birth *

School Grade

School

Mailing Address *

Allergies *

If yes, please list

Does child carry an EpiPen? *

Please indicate which programs your child will be participating in *

Parent/Guardian #1 Name: *

Parent/Guardian #1 Phone Number: *

Email Address

Parent/Guardian #2 Name

Parent/Guardian #2 Phone Number

Pick-Up Authorization (Include relationship to child) *

Tip: Who is authorized to pick up your child? (must be 16 years of age or with parental consent)

My child may be released following Kid's Church (Grade 4+ with consent)

Tip: Parent/Guardian Signature

Does your Child have any physical, emotional, mental, behavioral concerns or limitations that staff/volunteers should be aware of? *

If yes, please explain:

Permission for the reasonable use of pictures containing your student (select all that apply) *

Emergency Contact *

Emergency Contact Phone Number *

The safety of your child is our primary concern. Precautions will be taken for their well-being and protection.
I/we, the parents/guardians, named above, undertake and agree to indemnify and hold harmless Program Personnel, Organization, and its leaders from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Huron Chapel, as well as of any medical treatment authorized by the supervising individuals representing organiation. This consent and authorization is effective only when participating in Sunday morning kid's ministry events with Huron Chapel.

Purposes and Extent:

Huron Chapel is collecting and retaining this personal information for the purpose of enrolling your child in our programs, to assign the student to appropriate classses and to develop and nurture ongoing relationships with you and your child, and to inform you of programs updates and upcoming opportunities at our organization. This information will be maintained indefinitely as it is a requirement of our insurance company and legal counsel. If you wish Huron Chapel to limity the information collected or to view your child's information, please contact us.

Parent/Guardian Options:

I have read, understood and agree with the above and sign it to cover all Kid's Ministry activities for the program year. *

Parent/Guardian Printed Name *