CalvaryKids In-Take

Parent Information

Date

Parent/Guardian Name

Address

Phone

This address will receive a confirmation email

Alternative Emergency Contact Name

Alternative Emergency Contact Phone

Child's Information

Full Name

Address

Date of Birth

Grade

Allergies (If any)

Additional Children

Child # 1

Child #2

Child #3

Child #4

Child #5

Photo & Media Release

I give Calvary Assembly of God Church permission to take photographs and/or videos of my child during KidMin activities for use in church communications, social media, and promotional materials.

Photo & Media Consent

Yes, I consent No, I decline

Description

Please fill out CalvaryKids Intake.
Click submit.
Thank You!

CalvaryKids In-Take

Description

Please Fix the Following