CUMC Kids Ministry: Child Info & Liabilities

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Welcome to our 2021-22 year! We're so excited to welcome everyone back & meet new faces.

To be sure everyone is safe & we have the info we need for the year ahead, please complete the following form for EACH student in 0yo-5th grade!

(PS - you'll need some favorites from your kiddo, emergency contact info, and the Child's insurance card/doctor info to fill it all out! THANKS!).

*NOTE: You'll also need to print & sign the liabilities form by following the link here or at the end of the Google form for your student to participate. If you need a hard copy for whatever reason, let us know and we can make it happen!

Liabilities form can be accessed here: https://docs.google.com/document/d/1u3FcMLKj8cy6jJtKsfxpAaLepgPdpfMxjyRStzkLY-s/edit?usp=sharing

Child Name: *

School Attending: *

Primary Mode of Schooling (at date of completion, we know this may change due to COVID-19)? *

In-person

Virtual

Home-Schooling

Not in schooling yet

Child Grade for 2021-2022 (please select) *

Child's Date of Birth: *

YYYY

Child's Primary Address (please include city, state, ZIP) *

Child's favorite pizza topping? *

Pepperoni

Sausage

Cheese

Canadian Bacon

Hamburger

Pineapple & Ham

Child's favorite ice-cream topping? *

Child's hobbies or extracurricular activities? *

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