Parent /Guardian #1 *

Primary Contact

First Name

Last Name

Parent/Guardian #1 Phone *

(###)

###

####

Parent /Guardian #2

First Name

Last Name

Parent/Guardian #2 Phone

(###)

###

####

Family Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I am interested in registering for Sunday School for the following service: *

Morning (10-11 am)

Afternoon (1-2pm)

Child 1 *

First Name

Last Name

DOB Child 1

MM

DD

YYYY

Child 2

First Name

Last Name

DOB Child 2

MM

DD

YYYY

Child 3

First Name

Last Name

DOB Child 3

MM

DD

YYYY

Child 4

First Name

Last Name

DOB Child 4

MM

DD

YYYY

Terms and Conditions *

Terms and Conditions: 1. We ask that your child stay home: * If he or she is sick, has a fever, or symptoms similar to those of the flu or a cold, or symptoms consistent with any type of infection. * If you know that the child or someone in the household has been in contact with someone infected with COVID-19, as stipulated by the CDC (Center for Disease Control). 2. CLJ Kidz leadership will take all necessary steps to create a safe environment conducive to avoiding exposure to COVID-19. However, participation is at the family's risk and expense. The parent fully accepts this risk and holds the Lion of Judah Congregation and anyone involved in the CLJ Kidz ministry harmless from any legal liability. 3. In the event of an emergency requiring medical treatment for the child/children listed above, I understand that every effort will be made to contact me or my emergency contact. However, if they are unable to contact me or us, I give my permission to CLJ Kidz volunteers to obtain the services of a licensed physician to provide the care necessary for the well-being of my child. I assume responsibility for all costs related to any accident or treatment of my child. 4. I give permission for my child's photo/video to be used in publications and news programs for internal congregational use. I have read, understood and accepted the above information.

Accept