Registration

If you are new to our church or have not attended Sunday morning Kids Ministry for a few months, please fill out this form completely to register your child.

Child's Name*

First Last

Service Time*

Select9:00am11:00am

I acknowledge that the registrant has my permission to participate in Pathfinder Kids Ministry. I understand that when participating in Kids Ministry activities the registrant may be photographed for print, video, or electronic imaging. I understand that the images may be used in promotional materials for Pathfinder Church. I acknowledge that the images will be the sole property of Pathfinder Church.

Photo Release*

I acknowledge.

Name*

Date*

MM slash DD slash YYYY

Child's Birthday*

MM slash DD slash YYYY

Gender*

SelectMaleFemale

Parent's Name (1)*

First Last

Parent's Name (2)*

First Last

Address*

Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code

Primary Number*

Primary Number Owner*

Whose Number Is This?MotherFatherOther

Alternative Number*

Alternative Number Owner*

Whose Number Is This?MotherFatherOther

Email*

Child's Grade Level (Fall 2021)*

Select Grade LevelInfant (0-3 years old)Preschool (3-4 years old)Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade

For grades 6th-12th, visit Pathfinder Students

Child's Grade Level (Fall 2021)*

School*

Is Your Child Baptized?*

SelectYesNo

If yes, date of Baptism*

MM slash DD slash YYYY

Does your child have any allergies or special needs?*

• Allergies
• Special Needs
• None

Please list any allergies or special needs (ie. Autism, ADHD, Down Syndrome, sensory needs) we should know about.*

Special Needs Information

Your child is a wonderful creation of God and deserves to be treated in such a manner. Pathfinder Church desires to assist you in the spiritual education of your child in accordance with their special considerations. Take a moment to fill out the special considerations that need to be used when working with your child. Be aware that the adults and youth who will be working with your child are volunteers and they may not be professionally trained in your child’s specific needs area. We ask you to also understand that communication between buddies, parents, and leaders is very important and be sure to inform everyone involved of important information that may change throughout the weeks or year.

Special Need:*

Medication/Medical Concerns:*

Do you have any special instructions or tips to help us meet the needs of your child?*

Please list any other information that is helpful to us:*

When is a good time for the Coordinator to reach you to discuss a buddy for your child?*

Are you interested in serving in Kids Ministry?*

SelectYesNo

HEALTH PARENT CONSENT

I acknowledge that I have read and understand the communicated guidelines in response to COVID-19 and I give my informed consent for my child(ren) attending.

I agree to screen my child(ren) at home and keep them from attending if they have the symptoms related to COVID-19.

I will inform the ministry if my child has had any close contact with an individual diagnosed with COVID-19 or if we have traveled internationally or to a COVID-19 hot spot.

I agree to follow current guidelines and to be as supportive of Pathfinder Kids as they strive to make the best possible environment for student’s health, safety, and learning.

Health Consent*

I acknowledge.