Required fields *Child Name * Birth Date * Age * Grade * Names of Siblings Attending Address * Parent's Name - primary contact * Home Phone * Work/Cell Phone Parent's Email * Parent's Name - secondary contact Home Phone Work/Cell Phone Parent's Email Emergency Contact and Phone * Allergy/Health Conditions and “I permit my child’s name and food allergy to be posted for Kid's Ministry staff members to see. * YesNoN/AMy child has my permission to attend and participate in Kids Ministry program. (electronic parent signature and date) * Like Tweet +1 Pin it