North Shore Bible Church - Children\'s Ministry Signup

Name of your child

Name of Parents or guardians

Age/ Grade of your child

Contact Info (cell phone/ email...)

Address

Who would you like to authorize to pick up this child from our programs?

*Second grade and above may be released on their own only with specific written permission from parents/guardians. *Preschool – 1st grade children may be released to older siblings also, but only with specific written permission from parents/guardians.

MEDICAL INFORMATION: Please list any allergies or medical conditions, especially food allergies that your child has. Include information about any countermeasures (epi-pen auto-injectors, etc.) that the child knows how to use. Attach a separate sheet if necessary.

Is there anything else you would like us to know about your child that you think would be helpful as we care for them each week?

I have received the Parent’s Handbook, and agree to allow my child to participate in the children’s ministry programs of North Shore Bible Church.
Yes
No, I'd like to receive more info please!

We're looking forward to meeting you soon!

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