Child 1
*
First Name
Last Name
Preferred Name
*
Pronouns
*
Birthdate
*
MM
DD
YYYY
Grade and School as of Sept 2025
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Child 2
First Name
Last Name
Preferred Name
Pronouns
Birthdate
MM
DD
YYYY
Grade and School as of Sept 2025
Child 3
First Name
Last Name
Preferred Name
Pronouns
Birthdate
MM
DD
YYYY
Grade and School as of Sept 2025
Child 4
First Name
Last Name
Preferred Name
Pronouns
Birthdate
MM
DD
YYYY
Grade and School as of Sept 2025
Parent's Names (first and last)
*
Home Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email (include all addresses you'd like updates sent to)
*
Home/Cell Numbers
*
Emergency Contact (Name, relationship, contact number)
*
People authorized to sign child/children in/out of Children's Ministry (please include name, number and relations)
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Any allergies (food, seasonal, other), special needs that need to be taken into consideration, or other things we should know about your child that could help us make their time most enjoyable (or any diagnosis that is important for us to know)
How will we know if your child is stressed, needing support, or feeling overwhelmed?
What is the best way for us to support your child when they are feeling overwhelmed, angry, sad etc.?
Where can we surround and help your family feel more comfortable in Children's Ministry/Youth Programs at Wellington Square?
Permission to Drive - for Grades 7 and up
As a parent/guardian of (names listed above), I give them permission to ride in a vehicle with 18+ driver. (parent to be alerted when applicable)
Weekly Newsletter
Please sign me up to receive weekly e-blast communications from Wellington Square United Church via email regarding congregational events, important information, and other church updates. This will be the main communication regarding all children, youth, and family ministry programs happening.
I consent to allow Wellington Square United Church to use photos of my above-named child/children for promotional use and general display on church bulletin boards, church website, Facebook, and other promotional activities including live streaming and recording of Sunday Worship in the sanctuary, posted to YouTube. As a parent/guardian of the child/children named on this form, I hereby give permission for the subject of this release to be involved in the overall activities of the Wellington Square United Church Child/Youth programs. I/We understand all reasonable safety precautions will be taken at all times by Wellington Square United Church and its agents during the events and activities. I/We authorize any treatment by an accredited hospital and/or physician deemed necessary for the subject of the release in case of an emergency. I/We understand the possibility of unforeseen hazards and know the inherent possibility of risk. I/We agree not to hold Wellington Square United Church, its leaders, employees, and volunteer staff liable for damages, diseases, or injuries incurred by the subject(s) of this form. By typing your name here, you are signing this registration form electronically. You agree your electronic signature is the legal equivalent of your manual signature on this participation form.
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