Children & Preteen Ministry Registration

Please complete this registration form so that we can have your most current contact information! Please list all children birth through 8th grade. Thank you!


Today's Date
Family Last Name
Father First name
Mother First Name
Relationship to Tates Creek*



Address
City
State
Postal Code
Email Address
Home Phone
Cell Phone
Do you want to recieve text updates?
Best Way to Communicate?





Child #1 First and Last Name
Gender
Birthdate (mm/dd/yyyy)
Current Grade (if applicable)
School attended
Please list any special needs, allergies, or instructions for your child.

Child #2 First and Last Name
Gender
Birthdate (mm/dd/yyyy)
Current Grade (if applicable)
School attended
Please list any special needs, allergies, or instructions for your child.

Child #3 First and Last Name
Gender
Birthdate (mm/dd/yyyy)
Current Grade (if applicable)
School Attended
Please list any special needs, allergies, or instructions for your child.

Child #4 First and Last Name
Gender
Birthdate (mm/dd/yyyy)
Current Grade (if applicable)
School Attended
Please list any special needs, allergies, or instructions for your child.

Child #5 First and Last Name
Gender
Birthdate (mm/dd/yyyy)
Current Grade (if applicable)
School Attended
Please list any special needs, allergies, or instructions for your child.

Child #6 First and Last Name
Gender
Birthdate (mm/dd/yyyy)
Current Grade (if applicable)
School Attended
Please list any special needs, allergies, or instructions for your child.

I, the parent or legal guardian of the participant listed on this form, certify that he/she has my full approval to participate in the Tates Creek Christian Church event. Further, I do release and hereby agree to hold blameless Tates Creek Christian Church and its employees and agents from any and every claim arising, or which may be asserted any member of my family by reason of participating in any activities associated with Tates Creek Christian Church. I also release the lessor/owner of properties on which the program is held. I agree to pay for any damages or property loss as determined by Tates Creek Christian Church. Further, I do authorize the minister or sponsor of this activity or any Tates Creek Christian Church staff member, in the event I cannot be reached by phone, to give consent to a physician and/or hospital for emergency medical or surgical treatment while attending this event. It is understood that I will assume any financial responsibility for any expense that may be incurred for said emergency treatment. Further, I authorize Tates Creek Christian Church to use photographs and video footage of the participant for promotional materials. Further, I do certify that said participant is covered by adequate accident insurance. My consent and signature is given with the submission of this form. I have read and agree to the information given in this entire form.


Are Required Fields