Children's Ministry Registration Form

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This registration form ensures the safety of your child while he/she is in our care. It covers all regular and one-time events that are provided by our Children's Ministries.

Email *

Child's Name and Grade (if applicable) *

First and last name.

Child's Date of Birth

YYYY

Parent's Name *

Parent/Guardian Cell Phone Number(s) *

First and Last Name and Phone Number (please include all you think would be useful)

Ministry Requested (check all that apply)

Nursery (Age Newborn - 3 years)

Children's Church (Age 4 - 2nd grade)

9AM Sunday School (Age 4 - 5th grade)

Wednesday Evening Programs (Age Newborn - 5th grade)

Other:

Agreement with Westminster Children's Ministry Policies *

Please check the following boxes to indicate your understanding of and agreement with the policies of our Children's Ministry program.

My child and I agree to abide by the rules and regulations established by WPC for the health, safety, and welfare of the children attending the ministries.

I understand and acknowledge that my child’s participation in the WPC Children’s Ministries carries a risk of injury. I hereby agree to release and hold harmless any staff, officers, directors, employees and/or agents of WPC from any claims, costs, expenses (including attorney’s fees) and/or damages arising out of my child’s participation in WPC Children’s Ministries.

I understand that WPC does not provide accident or dental insurance, and that I shall be responsible for any and all medical bills should my child sustain an injury, illness, or loss of life in conjunction with his/her participation in a Children’s Ministry event, including (if applicable) transportation to and from the event activities.

I understand that my child may be traveling to or from various Children’s Ministries events in vans (including but not limited to 12 passenger or 15 passenger vans), buses leased or owned by WPC, or in privately-owned vehicles.

WPC reserves the right to dismiss any Children’s Ministries event participant whose conduct is deemed, as determined by the staff, as being detrimental to other children, staff, or any aspect of the Children’s Ministries event.

WPC reserves the right to deny enrollment, admission or participation in any Children’s Ministries event participant if that participant is found by staff to exhibit any physical or emotional behavior which would impede his/her ability to fully participate or prevent others from participating in any Children’s Ministries event activity.

WPC reserves the right to use any Children’s Ministries event participant in any promotional photographs or other materials produced in conjunction with the WPC Children’s Ministries event. The use of any Children’s Ministries event participant by WPC in connection with any aforementioned promotional activity shall not entitle the Children’s Ministries event participant to compensation from WPC.

WPC shall not be responsible for articles of clothing, personal effects or other belongings that are lost or damaged by fire, theft, other Children’s Ministries participants or staff.

I agree that this release covers each and every time the participant participates in any activity of WPC, whether on premises owned or operated by WPC or at any other location.

Trusting that those in charge will take every possible safety precaution and every possible attempt will be made to contact parents or guardians immediately in the event of injury or other emergency, I give my consent (in the event that I cannot be reached), to the physician selected by WPC to hospitalize, secure proper treatment for and to order injection, anesthesia or surgery for my child, and understand that I will be financially responsible for the treatment.

Required

Does your child have any allergies, medications or special medical concerns that we should be aware of?

If yes, list all that apply.

Useful Information about your Child

We want to provide the best possible care for your Child. What should we know? Are they potty training? Are snacks ok? Do they have any behavioral challenges? Special interests?

Should your child's activities be restricted for any reason? *

Yes. If yes, please be sure the restrictions are explained in your answer to the previous questions.

For children 2nd grade and under, please indicate the names of any adults that may collect your Child (with their security tag) at the end of the Class or service.

For children 3rd grade and older, please indicate if you give consent for your child to be release at the end of Class without a parent present.

I give consent for my Child to be released at the end of Class by the Teacher.

I do NOT give consent for my Child to be released; I will come to collect them.

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Date of Parent Permission *

YYYY

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

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