Children's Ministries Enrollment Form 2022-2023

This form should be filled out if your child is participating in any programs at St. Matthew's United Methodist Church. This includes: Sunday School, Nursery, Children's Worship, Club 56, and Choirs & Handbells.

Child Information

Last Name *

First Name *

Birthdate (mm/dd/yyyy) *

Address *

City *

State *

Zip Code *

Parent Email Address *

2nd Parent Email Address

School *

Grade *

ALLERGIES / MEDICAL INFO / SPECIAL NEEDS: (if none, please type none) *

Parent/Guardian Information

Parent/Guardian 1 Last Name *

Parent/Guardian 1 First Name *

Relationship to Child *

Address Line 1 (if different from child)

City (if different from child)

State (if different from child)

Zip Code

Primary Phone *

Secondary Phone

Parent/Guardian 2 Last Name

Parent/Guardian 2 First Name

Relationship to Child

Primary Phone

Secondary Phone

Emergency Contact

Emergency Contact (other than Parent or Guardian) *

Emergency Contact Phone *

Ministry Programs

Enroll in the following ministry programs by checking the appropriate item(s):

Sunday Ministries

Sunday School (18 Months - 6th Grade)

Nursery (0-3 years)

Children's Worship (4 years - 3rd Grade)

Club56 (5th and 6th Grade)

Music Ministries

Wesley Choir (Grades K-2)

Altar Choir (Grades 3-6)

Rainbow Ringers Handbell Choir (Grades 3-4)

Praise Ringers Handbell Choir (Grades 5-6)

Consent

Consent for Transportation: I give permission for the above named child to be transported during St. Matthew's events. Transportation may be by Church van or private vehicle. I understand that there will be supervision for each trip and that all passengers will be required to comply with church rules for travel. I also understand that the Church provides no insurance for transportation other than standard liability insurance coverage.

By typing my initials I agree to the Consent for Transportation statement above

Consent for Medical Treatment: In the event that the child named above is injured and requires the attention of a doctor, I consent to the rendering of routine or emergency medical/dental care necessary to preserve the health of my child, including diagnostic, medical and surgical treatment by authorized members of a outpatient, emergency or hospital staff or their designees, as may be in their professional judgment be necessary. In the event treatment is required from a physician and/or hospital personnel designated by the Church, I agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I also acknowledge that I will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by my health insurance provider. I also authorize first aid to be administered as judged to be needed by St. Matthew's staff.

By typing my initials I agree to the Consent for Medical Treatment statement above *

Consent for Photography: I give permission for photographs or video of the above named child to be taken during St. Matthew's events. These images could be used in publications, multimedia presentations, included on our web pages, St. Matthew's Facebook page or stored for the purposes of archiving. Web images will not identify child by name, and will not be used for commercial purposes.

By typing my initials I agree to the Consent for Photography statement above *

I have read and consent to my child’s participation, transportation, medical care, and photography. I understand that this consent will apply to all situations present and future, and that a copy of this form is as valid as the original. This consent is to remain in effect for one year from date signed or written revocation to the church is made.

By typing my initials I agree to the Consent statement above *