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Children’s Ministry Information Form

You are here: Home / Ministries / Children (Old) / Children / Children’s Ministry Information Form

Parent Information
Father's Name
First Last
Father's Cell Phone
Father's Email
Mother's Name
First Last
Mother's Cell Phone
Mother's Email
Does the child(ren) live with a grandparent(s) or other legal guardian?
- Yes
- No
Grandparent or Legal Guardian
First Last
Grandparent or Legal Guardian's Phone
Grandparent or Legal Guardian's Email
Do both parents live at the same address?
- Yes
- No
Address
Street Address Address Line 2 City State ZIP Code
Father's Address
Street Address Address Line 2 City State ZIP Code
Mother's Address
Street Address Address Line 2 City State ZIP Code
Child(ren)'s Address
Street Address Address Line 2 City State ZIP Code
Home Phone
IMPORTANT NOTE
Children in 5th grade or below must be picked up promptly by a parent or pre-arranged designated individual.
Emergency Contact Information
Emergency Contact Name*
First Last
Relationship*
Home / Cell Phone*
Work Phone
Email
Volunteer Options
Note: SLBC strongly encourages parents to be involved in Children's Ministry. Please consider one of the following:
Children's Ministry Teaching Options
- Select All
- Teaching in the Fall 2019
- Teaching in the Winter 2019-20
- Teaching in the Spring 2020
- Teaching in the Summer 2020
Other Children's Ministry Volunteer Options
- Serve as a teacher's assistant with my child's class
- Serve as a teacher's assistant in any class
- Occasionally serve as a substitute for Sunday School
- Occasionally serve as a substitute for Junior Church
- Help teach or assist with VBS (Vacation Bible School)
Interested in helping serve Children's Ministry in another way? Let us know below.
Please select number of Children*
Child 1
Name*
First Last
Date of Birth*
Grade*
Allergies or Medical Conditions
Child 2
Name
First Last
Date of Birth
Grade
Allergies or Medical Conditions
Child 3
Name
First Last
Date of Birth
Grade
Allergies or Medical Conditions
Child 4
Name
First Last
Date of Birth
Grade
Allergies or Medical Conditions
Child 5
Name
First Last
Date of Birth
Grade
Allergies or Medical Conditions
Child 6
Name
First Last
Date of Birth
Grade
Allergies or Medical Conditions
Medical Release (If I am not present)
If during any activity my child(ren) has a medical emergency (about which I understand I will be contacted as soon as possible), and I am not present or cannot be reached, I authorize an adult leader of SLBC to obtain and consent to any medical treatment that a medical practitioner determines necessary.
Medical Release*
- Yes, I give my consent to emergency medical treatment.
- No, I do not give my consent to emergency medical treatment.
Signature*
Publicity Release
Occasionally, SLBC may write about, photograph, videotape, or audiotape various activities and people at SLBC. This is most often done to highlight activities and to provide general information about programs, events, etc., related to SLBC.
Publicity Consent*
- I give permission to SLBC to use my child(ren)'s name(s), photos, in non-commercial promotional materials (Church publications, website, etc.) and publicity regarding various activities of SLBC. I hereby waive the right to inspect and approve finished photos or the use to which they may be put.
- No, I do not give permission to SLBC to use my child(ren)'s name(s), photos, in non-commercial promotional materials (Church publications, website, etc.) and publicity regarding various activities of SLBC.
Signature*

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281.491.7773

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