enroll formParent/Guardian InformationFull NameRelationship to ChildHome AddressPrimary Phone NumberEmail AddressEmergency Contact Name (if different)Emergency Contact Phone NumberChild Information(For each child enrolled)Full NameNickname (if applicable)Date of BirthAgeGenderGrade (if applicable)School Name (if applicable)Medical and Safety InformationKnown AllergiesMedical Conditions or Special NeedsDoctor’s Name and Phone NumberPreferred HospitalMedications (if any) Permission for Emergency Medical Treatment Program InformationCheckbox Field After-School Program Summer Program Bible Club, etc.Checkbox Field Monday–Friday Specific DaysPick-Up/Drop-Off AuthorizationSpiritual BackgroundOptional but helpful for a ministryIs your child familiar with Bible stories? Yes NoDoes your family attend a local church? Yes NoIf yes, Church NameConsent and Agreements Photo/Video Release Permission (for ministry events) Behavior Agreement (brief code of conduct acknowledgment)Submit Form
