2022-2023 Grace Kids Registration

Personal and Contact Information

Child's Name

Address

Mailing Address (if different):

Grade

Birthdate

Parent/Guardian 1

Cell Phone

This address will receive a confirmation email

Parent/Guardian 2:

Cell Phone

Medical and Emergency Information

Allergies

Does your child have any unique or special academic or behavioral needs? Are there any accommodations or supports that would help your child enjoy Grace Kids to the fullest?

The best way to contact me is:

Call Text Email

In case of an emergency please contact: (include Name/Cell #, may list up to 3)

Physician Name and Phone Number

Dentist Name and Phone Number

I give permission for my child's photo to be used on the Grace Church webpage and/or Facebook page:

Yes No

I have read and agree to the Permission Slip/Medical Release as found on the Grace Church website.

Yes No

I have read and agree with the Grace Kids Rules & Standards as found on the Grace Church website.

Yes No

Description

Please complete the Grace Kids Registration Form and click "submit".

2022-2023 Grace Kids Registration

Description

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