JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
UTMC Kids Church REGISTRATION
Required for Kids Church Attendance
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Child's Name
*
Your answer
Male or Female
*
Choose
Male
Female
Date of Birth
*
MM
/
DD
/
YYYY
Parent/Guardian Name
*
Your answer
Other Parent/Guardian Name(s)
*
Your answer
Phone Number
*
Your answer
E-mail Address
*
Your answer
Please List any Allergies
Your answer
Can we take pictures of your child for use within the church and social media?
Yes
No
Clear selection
Please list any health conditions your child has
Your answer
**UTMC teachers and helpers are not to give any medication. If your child needs medication, the parent or guardian must be present and administer it.**
I am interested in being an assistant in Kids Classes
Yes
No
Clear selection
I am interested in being a teacher in a Kids Class
Yes
No
Clear selection
*Children in JK - Grade 1 class MUST be picked up by a parent immediately after class.
*Children in Grade 2-4 may leave on their own following class.
Parent Name Filling Out the Form (In place of signature)
*
Your answer
I Will Sign Paper Waiver
*
YES
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Upper Thames Missionary Church.
Report Abuse
Forms
