Parents Name *
Parents Name
Address
Address
Phone
Phone
Child 1
Child 1
Gender
Birthdate
Birthdate
Child 2
Child 2
Gender
Birthdate
Birthdate
Child 3
Child 3
Gender
Birthdate
Birthdate
Consent *
I hereby give permission for my child to attend this church. I also give my permission for images of my child, captured during regular and special KWAM activities through video, photo, and digital camera to be used for the purposes of church promotional material and publications, and waive any rights of compensation or ownership thereto. I also understand, that I am agreeing to this waiver digitally.
Skating Party Release
I give my children, listed above, permission to attend the end of year skating party on April 30, 2019, at the Brush Skating Rink for 6:00-8:00. No transportation will be provided to the skating party. In case of emergency, I give permissions for my child to receive medical treatment. In case of such emergency, we will contact the number(s) on this registration form.
My Child will ride the bus: *
If you are unable to bring your child to KWAM, we do provide bus rides to and from KWAM. We have bus routes in both Fort Morgan and Brush. If your child will need a ride please let us know.