Child Registration

This form collects essential information for your child's participation in Beulah Church activities.

Please provide your (parent/guardian) name, email, and phone number in the section below. This information is for us to contact you regarding your child.

Further down, in the Child Information section, is where you'll provide all the necessary details about your child.

Your name *

Email address *

Phone number *

Address

Child Information

Below is how you add children to your household. Please fill out all pertaining information accurately, including Date of Birth, Gender, and any relevant medical conditions or allergies, to ensure we have complete and up-to-date records for your family.

Household members

Acknowledgment *

By checking the box below, I confirm that I am the parent or legal guardian of the child(ren) listed above and have the authority to grant this consent.

Permissions

Pick Up: 18+ Individuals Approved *

Snacks: Age-Appropriate *

Image Use Consent *

Do you consent to the use of your child's image(s) for church-related print materials, our website, and social media platforms?

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