Children's Ministry Program Registration
This form is required for any child attending Sunday School, the nursery, or mid-week programs and special events.  It covers from today's date forward.  If you have any changes in information at a later date, please email KamiF@MPCLife.org.  Thank you.
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Email *
Child's First Name *
Child's Last Name *
Child's Gender *
Street Address *
City, State, Zip *
Date of Birth *
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DD
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YYYY
Child's Grade for 2023-2024 School Year *
Current School *
Allergies/Medications/Other Needs or NONE *
Parent/Guardian (1) Full Name *
Parent/Guardian (1) Relationship to Child *
Parent/Guardian (1) Full Address, if different
Parent/Guardian (1) Resides with Child? *
Parent/Guardian (1) Phone Number *
Parent/Guardian (2) Full Name
Parent/Guardian (2) Relationship to Child
Parent/Guardian (2) Full Address, if different
Parent/Guardian (2) Resides with Child?
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Parent/Guardian (2) Email Address
Parent/Guardian (2) Phone Number
This permission form covers today's date forward. Future changes, email Children's Director: I/we give permission for my above-named child to participate in the Sunday morning, mid-week and other Children’s Ministry Programs of Moorpark Presbyterian Church. I/we hereby release Moorpark Presbyterian Church, its staff and sponsors, from responsibility and liability for any injury or illness that my child may sustain during any activity. I/we further understand that we and/or our insurance carrier assume full responsibility for all payments and costs of said emergency treatments. I/we also understand that my child may be photographed during these programs while participating in the various activities. I authorize permission for photos/videos of my child to appear on the website of Moorpark Presbyterian Church at MPCLife.org as well as in highlighting children’s programs on the church campus. In either case, my child’s name will not be used. Do you understand and agree? *
A copy of your responses will be emailed to the address you provided.
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