Children Registration Form

Please fill out the form below to register your children for children's activities at WCB.

Children's Registration

This form will be used for the entire Children's Ministry Program. Please select which areas you intend to register your child(ren) in for the year. 

Please note, space for Awana will be limited this year due to facility constraints, limited volunteers and the updated children protection policy.

Parent / Guardian Contact Info

Address*

,  

( )   -

( )   -

Child #1

( )   -

If attending youth activities (6th grade - 12th grade)

Attending

Note - Awana registration for the 2018-2019 year has closed.

Gender

Any Allergies

*If child has allergies, please complete the Special Medical Needs Agreement Form.

Child #2

( )   -

If attending youth activities (6th grade - 12th grade)

Attending

Note - Awana registration for the 2018-2019 year has closed.

Gender

Any Allergies

*If child has allergies, please complete the Special Medical Needs Agreement Form.

Child #3

( )   -

If attending youth activities (6th grade - 12th grade)

Attending

Note - Awana registration for the 2018-2019 year has closed.

Gender

Any Allergies

*If child has allergies, please complete the Special Medical Needs Agreement Form.

Child #4

( )   -

If attending youth activities (6th grade - 12th grade)

Attending

Note - Awana registration for the 2018-2019 year has closed.

Gender

Any Allergies

*If child has allergies, please complete the Special Medical Needs Agreement Form.

Child #5

( )   -

If attending youth activities (6th grade - 12th grade)

Attending

Note - Awana registration for the 2018-2019 year has closed.

Gender

Any Allergies

*If child has allergies, please complete the Special Medical Needs Agreement Form.

Emergency Contact

( )   -

( )   -

Check In & Check Out

You as parent/guardian are responsible for checking your child(ren) in each day and will be required to sign your child out. You must communicate with the current teacher/leader if someone other than yourself will be picking up your child(ren).

Please confirm you understand this process.*

I give permission to the following individuals to pick up the above listed child(ren):

Medical Release

In case of a medical emergency, I understand that first 911 will be contacted and then every effort will be made to contact the parents/guardians and emergency contacts listed.  In the event that I cannot be reached, I hereby give permission to WCB volunteers to contact appropriate medical staff to provide necessary medical services in the event that my child/youth is injured or becomes ill.  I authorize one or more of the following persons to make emergency medical care decisions on behalf of my child/youth: WCB Pastors and other adult volunteers designated by a pastor.  I authorize these persons to act in my place to consent to all necessary care.  I understand that WCB, staff, and volunteers will not be responsible for medical expenses incurred solely on the basis of this authorization.  Parents/guardians are responsible for the medical insurance coverage while their child is attending events and activities.  Medical treatment for any illnesses, injury, or medical situation for your child/youth will be billed to parents/guardians.  I further agree to notify WCB of any health changes that would restrict my child’s/youth’s participation in any normal activities.  I also understand that the WCB volunteers reserve the right to restrict my child/youth from any activity that they do not feel is within the physical capabilities of my child/youth. 

*

Photography Permission

I hereby give WCB Church permission to use photography of the above named child only for bulletin boards, children’s nursery cubbies, church media, and special events (e.g., carnival, VBS) at WCB Church.  Please check your response:

*

Parent Consent

I consent to have my child participate in the above listed activities of the West Center Baptist Children’s Ministry program, and certify that I will hold West Center Baptist Church, its directors, employees, volunteers, or agents from any and all liability and claims arising out of participation in or in the connection with the program or West Center Baptist Children’s Ministry program.

*

 

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