Kids' Church Registration

Welcome to Kids' Church! At Saalem, our goal is to help children apply the core principles of the Christian faith in their daily lives. We aim to create a safe, enjoyable, and engaging environment where they can experience the love of Jesus through songs, stories, memory work, role play, games and craft activities. Please complete this form to the best of your knowledge for our records. If you have any questions, please reach out to Jubin Abraham.

Your name *

Email address *

Gender *

Birthday *

Grade *

Address *

Phone number *

Parent/ Guardian’s Full Name: *

Medical Information

Please provide any information that is relevant to your youths' health.

Health Card Number *

Please provide an up to date version code as well as expiry date.

Allergies *

Medications *

Medical Conditions or Concerns *

Emergency Contact Person

Name *

Relationship *

Phone number *

Signatures

If the participant is under 18 years of age, the signature section must be completed by the participant's parent or legal guardian.

I give permission for photographs and/or filmed images of me (or my child) to be used by Saalem Church for promotional material and/or records. *

I give permission to allow Saalem Church leaders to provide transportation to and from events as they occur. *

I have completed the registration form with information that is accurate, complete, and true to the best of my knowledge. *

Electronically Signed By *

Date *

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