RG Kids - General Registration Form

Welcome to RG Kids!

We are glad you are here! To help us keep your child safe while in our care (including Sunday mornings and Wednesday nights), we ask that you answer a few questions.

Please complete one registration form for each child & click submit.

Have any questions? Call the church office at (417) 452-3670 or email: ddtaylor526@mail.com.

Child Information

Child's Full Name

Gender

Please select one option.

Male Female

Birthdate (MM/DD/YYYY)

Grade

Please select one option.

Preschool Kindergarten 1st 2nd 3rd 4th 5th 6th N/A

School Attending

Would you like to be contacted about special assistance for this child? (sensory, disability, special needs)

Please select all that apply.

yes no

Allergy (if any)

Guest of (if any)

Parent/Guardian Information

Parent/Guardian Name(s)

Address

Phone

Alternative Phone

This address will receive a confirmation email

What small group do you attend?

Other

Individuals (including older siblings) allowed to sign out child (other than parent(s) listed above). Please include full name and relationship to child.

By checking this box, I give permission for Round Grove Baptist Church to obtain medical attention in the event of an emergency (and when a parent or emergency contact cannot be reached)

Please select all that apply.

Yes

I give permission for my child's photos to be used in print/online at the discretion of Round Grove Baptist Church. I understand that my child will NOT be named or tagged in any photo.

Please select all that apply.

Yes No

Additional comments:

Form completed by: (name & relationship to child):

RG Kids - General Registration Form

Description

Please Fix the Following