Kid's Pre-Check | Mission Hills Church

WELCOME

We are so excited to meet you and your kids! Please use the form below to plan your visit to Mission Hills Church.
Parent's Name*
First Last
Email*
Phone
We’ll send you a reminder text message this weekend!
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Which service are you registering for?
After you complete your child’s information, you will be given an option to add additional children.
Kid #1 Name
Kid #1 Grade
Kid #1 Gender
Kid #1 Date of Birth
MM slash DD slash YYYY
Kid #1 - Any allergies or medical conditions?
Would You Like To Add Another Kid?
Kid #2 Name
Kid #2 Grade
Kid #2 Gender
Kid #2 Date of Birth
MM slash DD slash YYYY
Kid #2 - Any allergies or medical conditions?
Would You Like To Add Another Kid?
Kid #3 Name
Kid #3 Grade
Kid #3 Gender
Kid #3 Date of Birth
MM slash DD slash YYYY
Kid #3 - Any allergies or medical conditions?
Would You Like To Add Another Kid?
Kid #4 Name
Kid #4 Grade
Kid #4 Gender
Kid #4 Date of Birth
MM slash DD slash YYYY
Kid #4 - Any allergies or medical conditions?
Would You Like To Add Another Kid?
Kid #5 Name
Kid #5 Grade
Kid #5 Gender
Kid #5 Date of Birth
MM slash DD slash YYYY
Kid #5 - Any allergies or medical conditions?
Would You Like To Add Another Kid?
Kid #6 Name
Kid #6 Grade
Kid #6 Gender
Kid #6 Date of Birth
MM slash DD slash YYYY
Kid #6 - Any allergies or medical conditions?
MEDICAL | LIABILITY | PHOTO RELEASE*
I agree.
We realize no activity is without the possibility of unforeseen hazards which could result in injury to an individual. As a parent or guardian, you are aware of your responsibilities to instruct your child of the importance of conduct which will insure safety and enjoyable time while participating in the activity. By signing this form, you, as a parent, guardian or other responsible party, agree to assume the risks and hazards which are inherent in this kind of activity. You also agree to absolve and hold harmless the sponsoring organizations and their representatives for damage, loss or injury to the child for whom you sign.

I give my child, permission to participate in this activity, and give my permission to the leaders of this function to authorize any treatment deemed necessary by a licensed physician due to accident or illness during this activity. I further give my permission for the use of any photo or likeness of my child to be used by the sponsoring organizations for their use in promotional materials.

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