KIDS HOUR REGISTRATION FORM


-All classes start at 10:00 AM.

-Classes are open to children from birth to preschool age. Children must be accompanied by an adult.

We look forward to seeing you! If you have any questions or have trouble with this form, please call 770-928-7919.

Parents Name:*

Address (Street, City, Zip):

Phone Number:

Email Address:

1st Child's Name:

1st Child's Age:

2nd Child's Name:

2nd Child's Age:

Name of adult attending class:

Emergency contact:

Emergency contact's phone:

Do any of the children have allergies or other medical concerns we need to be aware of?

Do you have a church home where you are a member?*

I, the undersigned, understand that my participation and the participation of my child/children in this program is completely voluntary on my part, and I hereby give my permission for myself and my child/children to join in these activities. I shall hold harmless Beautiful Savior Lutheran Church, with its volunteers and employees, from any liability or responsibility for any accident, illness or injury that occurs during or as a result of these activities. I accept that the final responsibility for my safety and that of my child/children rests with me. I hereby authorize Beautiful Savior to take and use photography and/or video of my child for crafts, keepsakes, or promotional purposes in any type of media and understand I will not be compensated for any such use. Please type in your name below indicating your consent. Thanks!*