Light & Nightlight Child Registration Form ('24-'25)

Please fill out a separate form for each child in your family.

Child Info

Name

Birthdate

For example, 2/10/1996

Pronouns He/Him/His She/Her/Hers They/Them/Theirs Other

If you chose "other", please share your child's pronouns.

Gender

Female Male Non-Binary

Grade

3-year-old (Preschool) 4-year-old (Preschool) 5-year-old (Preschool) Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade

If you chose "other", which school does your child attend?

Adult Info

Adult Names

Address

Additional Address

An additional address can include a physical address (as opposed to a mailing address), or the address of your child's secondary home.

This address will receive a confirmation email

Phone

If you have multiple emails or phone numbers to use for regular communication, include a semicolon between them.

Participation Info

As you look at the fall, which program do you imagine your child will participate in?

LIGHT (Sundays at 10:45-11:30 am) NightLIGHT (Wednesdays, 7-7:45 or 8pm) Either as it works for our schedule Both

As you look at your fall schedule, how often do you anticipate your child will participate in LIGHT/NightLIGHT?

Does your child have an age-appropriate Bible at home?

Yes No, but we would like one No

Does your child have any food or life-threatening allergies?

Yes No

We often serve a snack during our programming. Do you consent to us providing your child with a snack, keeping in mind that we will provide an alternative for any known allergies.

Yes No

Is there any other information that would be helpful for us to know?

Media Release

We may share appropriate photos or videos of your child participating in our program to tell the story of our church on social media. If you have concerns with this, please reach out to Anna Wencl (annawencl@blcmankato.org)

I understand

Light & Nightlight Child Registration Form ('24-'25)

Description

Please Fix the Following