Form

#1 Child's Name

Birthdate

Male or Female

Age/School Grade

#2 Child's Name

Birthdate

Male or Female

Age/School Grade

#3 Child's Name

Birthdate

Male or Female

Age/School Grade

Parent's name

Address

Phone Number

E-mail

Emergency Contact and Phone #

As Parent/guardian of the above named children, I give permission for them to attend AWANA sponsored by Mansfield Bible Church. In the event of any accident, illness, or other problem which might occur, I will not hold Mansfield Bible Church or any of the church's volunteers liable. I constent to my child/children or me being photographed or videoed and for those pictures/videos to be used on MBC website and during MBC events.

Parent/Guardian Signature

DATE

For Kids Praise! to be successful, all parents need to help out or support Kids Praise! in some way. Please select the way(s) you are willing to help below.

Way to Serve

If you listed other above, please specify

Kids Praise Enrollment Form