2023-2024 NPC Kids Registration: Please complete ONE PER CHILD.

Please fill out this form for any child who will be involved in NPC Kids ministry (Nursery, Sunday School, Worship & Play Zone). One entry per child.

In the first line, please enter CHILD'S NAME. There is a spot for parent/guardian information below that.

Note for the grade field - please select the program age for the 2023-2024 school year.

Name

Birthdate

Grade

Please select one option.

Nursery Pre-Kindergarten Kindergarten 1st 2nd 3rd 4th 5th

Parent/Guardian #1 Name

Parent/Guardian #1 Email

This address will receive a confirmation email

Parent/Guardian #1 Phone

Parent/Guardian #2 Name

Parent/Guardian #2 Email

This address will receive a confirmation email

Parent/Guardian #2 Phone

Emergency Contact Name (if other than parent)

Emergency Contact phone number

Address

Do you consent to your child's photos being used in newsletters, promotional tools like brochures, social media, or other uses deemed appropriate by Neelsville Presbyterian Church?

Please select one option.

Yes No

Does your child have any medical concerns and/or allergies? Please comment name & concern, otherwise type 'no'.

Please describe anything else that would be helpful for us to know about your child so we can best minister to him/her.

I give permission for Neelsville staff and leaders to call emergency personnel and give appropriate treatment for my child in the event I cannot be reached during a medical emergency. I understand that I, the parent or guardian, have financial responsibilty and liability for my child's illness or injury incurred on site at Neelsville Presbyterian Church or at an event location.

Please select one option.

Agree

I am willing to volunteer

Please select all that apply.

in the nursery in a Sunday School classroom in Worship & Play Zone Unfortunately, I cannot volunteer at this time.

Please type your first and last name as the person who completed this form. This serves as your digital signature.

Description

Please fill out this form for any child who will be involved in NPC Kids ministry (Nursery, Sunday School, Worship & Play Zone). One entry per child.

2023-2024 NPC Kids Registration: Please complete ONE PER CHILD.

Description

Please Fix the Following