Grace Community Church - TeamKID Online Registration 2026-27

Participant Name

Participant Sex

Male Female

Participant Birthdate

Grade

potty trained pre K Kindergarten First Second Third Fourth Fifth

(To register more than one child, type their names, age, grade, and allergy info here. )

Parent/Guardian Name

This address will receive a confirmation email

Phone

Address

Home Church (if any)

Emergency contact name

Emergency contact phone number

Individuals authorized to pick up the student

Student's doctor/contact number

Specific allergies, illnesses or other conditions?

As a parent and/or legal guardian, I do hereby authorize the treatment by a qualified and licensed medical doctor of the above minor in the event of a medical emergency which, in the opinion of the attending physician, may endanger his or her life, and/or cause disfigurement, physical impairment, or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to contact me. This release form is completed and signed of my own free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence. By checking yes in the box provided, I am giving medical consent for my child to be treated if needed.

Yes No

Optional: Use this space to tell us anything we should know about your child

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Grace Community Church - TeamKID Online Registration 2026-27

Description

Please Fix the Following