K-5 Alive Spring 2019 Registration Form

We will be starting a series called INCREDIBLE FAITH. This series will focus on 10 heroes whose faith in God allowed them to be used by God to save the day. Kids will learn that they can put their faith in God, because he is worthy of our trust.

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* 1. Participant's Full Name:

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* 2. Preferred Name:

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* 3. Date of Birth:

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* 4. Grade in 2018-2019:

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* 5. School:

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* 6. Mailing Address:

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* 7. Mother's Name:

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* 8. Mother's Cell Number:

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* 9. Mother's Email:

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* 10. Father's Name:

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* 11. Father's Cell Number:

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* 12. Father's Email:

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* 13. Emergency Contact Name:

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* 14. Emergency Contact Phone:

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* 15. Emergency Contact Relationship:

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* 16. Please list any allergies, physical or academic limitations, medications needed, or anything else that we should be aware of regarding your child: 

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* 17. Parent Permission and Waiver of Liability:
I give permission to my child to participate in WCUMC’s K-5 Program to be held on Wednesdays, January 9- March 20 from 4:30-6:30 at WCUMC. I understand that the children are asked to share and participate in discussions and activities.

I also understand that my child is expected to sing on March 24, 2019 at 3 pm at Wesleyan Chapel UMC. I also consent to my child being photographed by church representatives while participating in this event for use in church communications, publications, bulletin boards, and on the church website. I have read and understand the Safe Sanctuaries policy found on the WCUMC website www.wesleyanchapel.org.

Parent Signature (Please Type Name):

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* 18. Date:

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* 19. Participant Covenant:
I agree to follow all rules participate fully in activities, and respect the adult leaders and other students at all times during the above named event. I understand that if, at any time, leaders determine I am not following through with this covenant; my parents can be contacted and I may be unable to participate in this event.

Child's Signature (Please Type Name):

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* 20. Date:

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