Rincon Congregational UCC
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Child/Youth information
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Address
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Parent/Caregiver's Phone number
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Parent/Caregiver's email address
Emergency Contact
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Emergency Contact Phone Number
Child #1
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Child #2
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Child #4
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Child #1 Allergies/Medical Concerns
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Child #1 Interests
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Child #1 Permission
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Do you grant permission to use photos of your child in church publications, slide shows, website, etc?
Child #2 Allergies/Medical Concerns
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Please list any allergies or medical concerns
Child #2 Interests
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List any special interests or activities your child likes
Child #2 Permission
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Child #3 Allergies/Medicla Concerns
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Please list any allergies or medical concerns
Child #3 Interests
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List any special interests or activities your child likes
Child #3 Permission
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Do you grant permission to use photos of your child in church publications, slide shows, website, etc?
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