Child Registration 2021-2022 KidzRock

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SUNDAY KidzRock
September 12th through May 15th from 9:30 am - 10:30 am. Drop off starts at 9:20am.
The following Sundays we do not meet: Nov. 28th, Dec. 26th, Jan 2nd, March 13th, March 20th and April 17th.
**3 year olds MUST TURN 3 BY September 15, 2021.

WEDNESDAY POW - Parents attend small group while Kids attend programming
September 15th through November 17th and then January 19th through April 27th. We take a break for Advent in December, March 2nd for Ash Wednesday and then take spring break week off for March 16th. If Cedar Falls Schools gets out early or is canceled on a Wednesday due to weather that automatically cancels Wednesday night student programming.

Questions or Concerns:

Please contact kidz@naz.org or call NAZ at (319) 266-7589
Kim Albertsen, Director of Children's and Family Ministry ~ kim.albertsen@naz.org
Meg Husted, Family Coordinator ~ meg.husted@naz.org

Email *

Child's First Name *

Child's Last Name *

Child's Date of Birth *

YYYY

Child's Gender? *

Male

Female

Required

Child's Grade *

3 Year Old Pre-K (3 years old by Sept 15, 2021)

4/5 Year Old Pre-K

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

6th Grade

Other:

Medical Conditions and/or Behavioral Concerns (Including Allergies) *

If your child has no known medical conditions or behavioral concerns, please type none.

Child's Current School *

Child's Mailing Address *

Zip Code *

Parent/Guardian First and Last Name *

Parent/Guardian Phone Number *

Parent/Guardian Mailing Address if different than the child's

Secondary Parent/Guardian First and Last Name

Secondary Parent/Guardian Email Address

Secondary Parent/Guardian Phone Number

Do you have a "KidCheck" account? *

YES

Not Sure

Required

What is the phone number associated with the KidCheck account? *

POW (Parents on Wednesday)- Wednesday Nights beginning 9/15/21 6pm - 715pm | studying the book of Colossians *

Yes, I'm in! Contact me about completing registration

Maybe, contact me about more details please!

No, we won't be able to participate.

Required

Would you attend a "parent" Sunday where parents would get to participate in a portion of Kidzrock with your child? Please share your thoughts as we explore this possibility. *

Photo/Video Release: Photographic and Video Recording devices will be used at this event and the images captured could be used for publicity and/or historical purposes in a print or web-based media outlet. *

YES. I grant Nazareth Evangelical Lutheran Church permission to use my child's likeness and name in photographs, video recordings and/or electronic images in any and all of its publications, including website entries and social media posts.

NO. I do not grant Nazareth Evangelical Lutheran Church permission to use my child's likeness in photographs, video recordings and/or electronic images in any and all of its publications, including website entries and social media posts

Required

Does Children's Ministry have permission to give your household information to the Nazareth Church Database? This will include receiving a few extra emails a year (for example, fall kick off, Christmas and Easter invites, plus the 4 quarterly newsletters). *

Yes I give permission for my household information to be given to Nazareth to update the database and used for what we have agreed upon

No I do not wish to at this time.

Additional Information:

A copy of your responses will be emailed to the address you provided.

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