* 1. Child's First and Last Name

* 2. Goes By Name (if different)

* 3. Date of Birth

Date
/
/

* 4. Home Address

* 5. School Grade

* 6. List any allergies or other medical issues. 

* 7. What are your child's strengths and gifts they can share with the class?

* 8. What are challenges that your child might bring to the class?

* 9. Parent/Guardian 1

* 10. Parent/Guardian 2

* 11. Parent support is needed to make our program successful, please check at least one of the following ways in which you are able to volunteer with our program.

* 12. Do you give permission for your child's photo to be used in Saint Stephen's publications and on our website/social media?  Names of the children will not be printed. 

* 13. Do you give permission for trained church staff to perform general First Aid on your child if needed?

* 14. Do you give permission for church staff to call 9-1-1 for your child if an emergency situation occurs and and to make emergency medical decisions for your child if you cannot be reached?

* 15. Children's Ministry Behavior Expectations
*All children, adults and volunteers should feel welcomed and safe in our church buildings, classrooms, the playground and at all other church events.
*All children, adults and volunteers will be respected. Bullying will not be tolerated.
*The church playground, buildings, classrooms, materials and supplies will be treated with care.
*Parents/Guardians will be notified if their child exhibits disruptive or unacceptable behavior.
By initialing below I acknowledge that I have read and understand the Children's Ministry Behavior Expectations and we will discuss them as a family.  Please initial in the box.

T