Good Sam Kids Registration

Good Sam Kids

Parent/Guardian Information

Full Name

Phone Number

Email Address

Child's Full Name

Date of Birth

Age

Grade / Class

Allergies / Medical Conditions

Special Instructions or Notes

Provide a contact person in case the parent/guardian cannot be reached.

Full Name

Phone Number

Relationship to Child

I grant permission for my child to be included in photographs and videos taken during ministry activities for church promotional purposes.

I understand and agree to the terms of the liability waiver, releasing the church from any liability for injuries that may occur.

Thank you for registering your child for Good Sam Kids. We look forward to seeing you!