Kid's Ministry Registration Form

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Dear Parent: Please fill out the information below along with the medical release information for each child involved with activities at Gospel Tabernacle COGIC. If any information changes, throughout the year, please let us know. It is very important to have this information to keep records up to date.

Email *

Today's Date *

YYYY

Child's Full Name *

Child's Address *

Child's Date of Birth *

YYYY

Grade

School

Severe Allergies: *

Yes

Epi Pen

Inhaler

Required

Please List Allergies

Food Allergies *

Yes

Please List Food Allergies

I have a child with special needs *

Yes

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