Summer Kids Club

Summer Kids Club Registration

LAST DAY TO REGISTER 5/19/24

First child - $20
Second child - $15
Additional children - $10/each
EXAMPLE - Family with 3 children would be $45

Pay for Summer Kids Club online

Please register each child separate

Kids Club Registration Form

* Indicates required field

Child's Name *

Gender *

Age *

Grade *

Date of Birth (mm/dd/yyyy) *

T Shirt Size *

Allergies/Medical concerns *

Photo Release: I authorize my child to be photographed for the purposes of advertisement for Summer Kids Club. *

Yes No

Name of Parent(s)/Guardian *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Parent/Guardian Cell Phone *

Home Phone *

Email *

Church you attend *

Emergency Contact Name/Number *

Medical Release

In consideration for my children (listed above) being allowed to participate in the Summer Kids Club, on behalf of my child, my spouse and myself, I hereby assume all risks in connection with Summer Kids Club and I further release Lifeline Church, the Pastoral Staff, or Teachers thereof from all claims, judgments, liability for any injury or damage that the child or his/her estate, myself or my spouse ever had, now has or may have due to the child's participation in the Summer Kids Club, including all risks connected therewith whether foreseen or unforeseen.(including health risks such as, but not limited to, COVID-19) I fully understand what is involved in Summer Kids Club and I understand that I have the opportunity to call the church and/or Leader and ask him/her about the Summer Kids Club.

By selecting the box below you agree to the above medical release form. *

Agree to Medical Release Conditions

Submit

Summer Kids Club Registration

LAST DAY TO REGISTER 5/19/24

Kids Club Registration Form

Medical Release

You must pay after registering to hold your spot.

Connect with Lifeline

Summer Kids Club Registration​LAST DAY TO REGISTER 5/19/24

Kids Club Registration Form

Medical Release

You must pay after registering to hold your spot.

Connect with Lifeline

Summer Kids Club Registration

LAST DAY TO REGISTER 5/19/24