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HopeNYC Kids Church Registration form: 5/16/2021
Welcome to Hope Kids Church. Please complete the questions below. A separate registration must be completed for each child. Masks are required.
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Child’s FIRST NAME and LAST NAME?
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Your answer
Child's age. (in years only please)
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Your answer
First and Last Name of Parent(s)/Guardian
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Your answer
Parent/Guardian’s cell phone number?
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Your answer
Allergies: Does child have allergies to medication, food or other? If yes, please explain.
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Your answer
Health Concerns and food restrictions: Does the student have any health conditions, food restrictions and/or challenges that we should be made aware of? If yes, please explain.
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Your answer
Name and cell phone number of Authorized person(s) that can pickup your child.
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Your answer
I give permission to HopeNYC to photograph/video/post on social media or use for marketing, my child. I also release HopeNYC of any liability.
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Yes
No
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