WICKLINE KIDS REGISTRATION FORM

Sunday School *
WOW Kids - Wednesdays August-May, Dinner 5:15, Small Groups 6:00-7:30pm *
WOW Kids will be studying Trackers of Truth from Seedbed.
Student's Name *
Student's Name
Parent/Guardian Name *
Parent/Guardian Name
Address *
Address
Phone *
Phone
Student Date of Birth *
Student Date of Birth
Emergency Contact #1 *
Emergency Contact #1
Emergency Contact #1 Phone *
Emergency Contact #1 Phone
Emergency Contact #2
Emergency Contact #2
Emergency Contact #2 Phone
Emergency Contact #2 Phone
Media Consent Form *
I consent to the use of my child's image or voice in photographs, audio, and/or video recordings taken during the course of the Wickline United Methodist activities. These images will be used for the purpose of publicizing the programs, including but not limited to use in the church newsletter, during worship services of the church, placement on the church's internet website, and placement on church bulletin boards. If you DO NOT want your child's image or voice used, please complete the above form and mark "I do not agree" below.
Date Form Completed *
Date Form Completed
Parent/Legal Guardian's Name (Signature) *
Parent/Legal Guardian's Name (Signature)
Submittal of this form will be accepted as intent to register your child in the activities selected. Please type your name in the blocks provided.