Junior church membership

JUNIOR CHURCH APPLICATION FORM

CHILD'S DETAILS

Name

First Name

Last Name

Date

MM

DD

YYYY

Age

Grade

Allergies

RESPONSIBLE PERSONS DETAILS

Name

First Name

Last Name

Relationship to Child

Phone

(###)

###

####

Email

Waiver and Indemity Form

I have read and accept the waiver and indemnity form

I acknowledge that if my child is on any medication it is NOT the responsibility of the teacher to administer

Waiver & indemnity form