Kids Online Book Club Registration Form
Join us for Kids Online Book Club!
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First, Middle, and Last Name of Minor Child *
Age and Grade of Participant
Activity Release: I give permission for the child/youth named above to participate in the activity listed above and understand that I will need to be present, though not necessarily participating*, while my child/youth attends. *
*Youth Work Certified parents are invited to participate as volunteers in Book Club f they are interested. However, marking yes to this question does not require you to participate, it only affirms that you understand you need to be present when your child attends.
Required
Photo Release: I give consent to and authorize Community of Christ, its successors, legal representatives and assigns, to use and reproduce the name, voice, and likeness (photographs, illustrations, video tape, Web site, or film) of the above named child/youth taken during this activity and circulate same for any and all official resource, use, or purpose including print, film, or electronic reproduction of every description.  Consideration is hereby waived and no further claim of whatsoever nature will be made by me. No representations have been made to me. *
Where should we send the link for Zoom meetings? *
Mailing address
Name of legal guardian *
Phone number at which you can be reached during the activity *
Name and phone number of a person who can be called if we cannot reach you *
Are there any special needs or considerations your child has that we should be aware of?
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