Full Parent/Guardian Name (Required)

Your Address (Required)

Phone Number (Required)

Email Address (Required)

Emergency Contact Name (Required)

Emergency Contact Phone Number (Required)

Emergency Contact Relationship to Child (Required)

Child’s Name (Required)

Child’s Date of Birth (Required)

Allergies or Medical Info (Required)

Special Accomodations/Needs (Required)

I give permission for my child’s photos/videos to be used for church media and promotional purposes. (Required)

In case of emergency, I authorize Kingdom Kids staff to seek necessary medical attention for my child. (Required)

I understand that Kingdom Kids is a faith-based program and agree to support my child’s participation in Bible-based lessons and activities. (Required)