OHC Kids Registration • Orchard Hills Church

Parent #1 Information

First Name *

Last Name *

Relationship to Child *

Mother

Father

Other

Cell Number *

Tip: enter a number in case you need to be reached during the service via text

Email Address

Tip: Please enter parent email

Parent #2 Information

First Name

Last Name

Relationship to Child

Mother

Father

Other

Cell Number

Email Address

Child Information

Child First Name *

Child Last Name *

Date of Birth *

School Grade *

Tip: Current or last completed

Other Medical Information

Tip: Anything relevant that may be helpful

Special Needs or additional information that would be helpful to the children's ministry staff:

Drop-off / Pick-up

If someone OTHER than the parents/guardians listed above is picking up your child(ren), please provide their information below. If not leave blank.

Name

Phone Number

Relationship

Photo Release

On occasion, Orchard Hills Church uses photo and video on it's website, social media sites, and other church related publicity. Please select to Opt-Out if you want your child to be excluded for public publishing.

Photo Opt-Out

I DO NOT want photos of my child to be displayed in church publications, e.g. website, newsletters, etc