Children's Ministry Registration Form
PARENT/GUARDIAN #1
Name
*
Cell Phone #
*
Do we have permission to text this number?
*
Yes
No
PARENT/GUARDIAN #2
Name
Cell Phone #
Do we have permission to text this number?
Yes
No
Primary Street Address
*
City
*
State
*
ZIP Code
*
Primary email address
*
Additional Emergency Contact Name
Additional Emergency Contact Phone
Photography Release: Registration in Children's Ministry programs authorizes Platte Woods UMC to take photographs and/or videos during Children's Ministry events and classes. Photos and videos may be used in promotional materials including, but not limited to, websites, social media, printed materials. To opt out, please check the box below.
Opt-Out
Please do not use photographs or video of my child(ren).
I am registering my child(ren) to be placed on a Children's Ministry roster at the following time(s):
*
Saturdays at 5 p.m.
Sundays at 8:15 a.m.
Sundays at 9:15 a.m.
Sundays at 10:45 a.m.
Wednesdays at 6 p.m.
CHILD #1
Full Name
*
Gender
*
Date of Birth
*
Grade (2018-19 school year)
School
CHILD #2
Full Name
Gender
Date of Birth
Grade (2018-19 school year)
School
CHILD #3
Full Name
Gender
Date of Birth
Grade (2018-19 school year)
School
CHILD #4
Full Name
Gender
Date of Birth
Grade (2018-19 school year)
School
Information: PWUMC wants each child to be successful and safe while participating in Children's Ministry activities. Does your child have any allergies, medical conditions, learning differences, or any other special need of which our ministry team should be aware? If yes, please list below.
List: