Explorers/ Children's Church Registration form

Explorers/ Children's Church Registration form

Westview Baptist Church
Parent/ Guardian Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent or guardian email
Phone Number of parent or gaurdian *

Area Code Phone Number
Emergency contact's name *

First Name Last Name
Emergency contact number *

Area Code Phone Number
Emergency contacts relation to child *
Authorized for pick up *

Mother Sibling Father Emergency contact
Are you part of a Faith community?
We like to promote our Explorer's programs by taking and posting photos or video on our social media, on our webpage, to share with our church, and sometimes to make crafts. Please let us know if we can take your child's photo.

Yes, you can use my child's photo Yes, you can use my child's photo, but do not include a name Please only use my child's photo for personal crafts Please do not take my child's photo
Child's name *

First Name Last Name
Grade *
Child's Birthday *

Month Day Year
Date
My child is interested in participating in (Check all that apply):

Children's Church on Sunday mornings Explorers Midweek Program on Wednesday evenings at 6:30 p.m.-8
Allergies/ Medical Concerns
Health card No. (optional)
Second Child's name (optional)
Child's Birthday

Month Day Year
Date
Child lives with

Mother Both parents Father Other
My child is interested in participating in (Check all that apply):

Explorers Midweek Program on Wednesday evenings at 6:30 p.m.-8 Children's Church on Sunday mornings
Concerns
Health card No. (optional)
In the event that we cannot meet in-person we will plan to meet online through Google Meets or Zoom.

As part of our safety policy we follow these guidelines
- 2 approved leaders will be present
- We ask that a parent be present during check in and remain in the room while the session is in progress
- We encourage the use of speakers on your computer rather than using headphones
Do you give permission for your child to meet with scheduled Westview Baptist Church Children's Ministry programs? *

yes no
Precations are taken for the health and saftey of your child, but in the event of an accident or sickness, Westview Baptist church, its staff, and volunteers are hereby released from any liability. In the event that your child requires special medication, X rays, or treatment, the parents or gaurdians will be notified immediatly.

If your child needs medication for any condition (Eg, EpiPen) written consent must be given to a specific person(s) before we can administer the medication.

Covid protocols: Precautions are being taken to keep children safe from the possible transmission of the covid virus. Children and leaders are expected to complete daily screening from covid symptoms, to wear a mask (only if required by the health unit), to maintain the required physical distancing, and to adhere to recommended covid guidelines as set out by the London Middlesex Health Unit.
Please type "yes" if you have read and agree to the above statement. *
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