Child-Preteen-Youth Ministry Registration Form - First United Methodist Church

Use the form below to register your child, preteen or youth for small groups, Sunday school and to receive notifications on upcoming events for children and youth at First United Methodist Church:

2021-2022 Children's, Preteen & Youth Registration

Child's First and Last Name*
First Last
Child's Birthday*
MM
DD
YYYY
What grade will your child be entering in the fall of 2021?*
Add additional children or youth here:
Name Birthday Grade your child/youth will enter in the fall of 2021)
Parental Contact Information
Parent/Guardian # 1's Name*
First Last
Parent/Guardian # 1's Cell Phone*
Parent/Guardian # 1's Email*
Parent/Guardian #1's Address*
Street Address Address Line 2 City State ZIP Code
Parent/Guardian #2's Name
First Last
Parent/Guardian #2's Cell Phone
Parent/Guardian #2's Email
Adults or Siblings who are allowed to pick-up your child
Allergies / Special Information about your child that we should know
I give permission for FUMC to photograph my child during church events for advertising purposes: website, newsletter, magazine, etc*
- Yes
- No
In case of emergency, and parents cannot be reached, I give permission to the personnel of First United Methodist Church to take my child to the nearest medical facility. I authorize the personnel of FUMC to secure medical treatment by their doctor or associates, as deemed necessary.
- Agree
Signature*
Date*
Date Format: MM slash DD slash YYYY

Name	Birthday	Grade your child/youth will enter in the fall of 2021)

2021-2022 Children's, Preteen & Youth Registration

Parental Contact Information