LakePoint Kids Registration Preschool - Grade 5
Please fill out this form and click submit.
Child's Full Name
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Child's Birthdate: (DD-MM-YY)
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Allergies/Medical concerns we should know about to provide a safe environment for this child:
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Please list all parent(s)/guardian(s) the child lives with:
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What is their relationship to the child for the names listed above:
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Best contact number for all parent(s)/guardian(s):
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Please list any other people who can pick up the child, as well as their relationship to the child and their contact number:
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Child's Home Address
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Family Email Address
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This address will receive a confirmation email
Please read the following statements carefully and check the appropriate boxes.
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Please select all that apply.
I give permission for the child listed above to participate in the programs at LakePoint Family Church. I release LakePoint Family Church from liability for injury or loss related to his/her participation and authorize them to take action to protect my ch
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Please select all that apply.
I give permission for staff and volunteers to take photographs or videos of my child for promotional or advertising purposes.
OR I do not give permission for staff and volunteers to take photographs or videos of my child for promotional or advertising purposes.
Today's Date
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Please type your name in lieu of your signature
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Submit
Description
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