Parent Name *
Parent Name
Parent name
Parent name
Would you like to receive email notifications of Kid's Station activities/events? *
Would you like to receive email Parent Newsletter *
Child's Name *
Child's Name
Birthday *
Birthday
i.e. slow warm up time, easily frustrated.
Photograph & Video Release Form. Throughout the year, there may be times when Christ’s Family Church (CFC) staff, the media, or other organizations, with the approval of the staff, may take photographs of students, audiotape/videotape students, or interview students for church-related stories in a way that would individually identify a specific student. Those photographs and/or audio/videotaped images or interviews may appear in church publications; in church video productions; on the church Web site; in the news media; or in other nonprofit, education-related organizations’ publications. Please complete this form, and return it to Christ’s Family Church. ❑ I hereby grant Christ’s Family Church Staff, or designated volunteer, permission to use my child’s photograph and/or videotaped image for the purposes mentioned above. I understand and agree that CFC may use these photos and/or videotaped images in subsequent years unless I revoke this authorization by notifying the church in writing. I further grant unto CFC permission to allow my child to be photographed, audio/ videotaped, or interviewed by the news media or other organizations for church-related stories or articles. *
I give permission for my child to participate in all aspects of Youth Ministries both on and off site. I understand that every effort will be made to contact me if my child needs emergency medical treatment. I authorize CFC staff and youth ministry volunteers to secure any medical or emergency treatments deemed necessary for my child. My insurance company or I will pay for any medical treatment if const are incurred.