Hope Kidz Club 2023-24 Registration Form

Living Hope Church's Hope Kidz Club will be at Kennedy Elementary School!

Hope Kidz Club
is a high energy weekly Bible club for kids which includes music, snacks, games, Bible stories and FUN!!!!!

Who Teaches the Club?
All our volunteers are trained and care about children. We want to partner with you teaching your children life changing principles that can be applied now and as they grow up.

When: Every Wednesday
Where: Kennedy Elementary School Gym
Who: All boys and girls, grades K-5th, regardless of religious background.

Parents are welcome to come and volunteer!

Wednesdays
September 27, 2023- April 24, 2024
Start Time 1:05pm
End Time 2:35pm

Student Information

Name

School

Teacher

Grade

Check One

Male Female

Date of Birth

Age

Street Address

Apartment #

City

State

Zip

List any Security/Custody issues with this child

List any special needs (ADD, Autism spectrum disorder, Dyslexia, etc.)

Child's Allergies (peanuts, chocolate, etc.)

Parental/Legal Guardian Information

Home Phone

Family Email

Father's Full Name

Cell Phone

Mother's Full Name

Cell Phone

Church

Emergency Contact Information

Emergency Contact #1 Full Name

Phone Number

Emergency Contact #2 Full Name

Phone Number

My child is allowed to attend the Hope Kidz Club on Wednesdays after school. The club will run until April 24, 2024. Clubs will run concurrent with the school calendar. I understand it is my responsibility to pick up my child at 2:35pm and failure to do so will jeopardize my child's continued participation.

Yes

Check next to the option(s) that apply to your child:

My child will be picked up after Hope Kidz Club My child will walk home after Hope Kidz My child is registered for and will attend the Kids Unlimited program for the after-school program I do not want my child photographed for advertising purposes

Please Note: Parents must pick up each child promptly. Our policies do not allow Hope Kidz Volunteers to remain after club. If your child is not picked up immediately after club three times throughout the school year, he/she will not be allowed to continue attending.

Permission for Pickup

In addition to those listed above, the following people may pick up my child:

Full Name #1

Phone Number

Full Name #2

Phone Number

We would love parents/guardians to volunteer with Hope Kidz at least one time during the school year. If you would like to join the fun please leave your name and phone number below.

Signature

Typing your full name signifies you are completing this form using an electronic signature. By signing electronically, you are certifying that you have read and understand the information listed above and agree to electronically sign. You acknowledge that all the information listed above is true to the best of your knowledge. To continue with the electronic signature process, please enter your name and click the ‘Submit’ button to save your information and submit your electronic signature.

Full Name

Description

Wednesdays
September 27, 2023- April 24, 2024
Start Time 1:05pm
End Time 2:35pm

Hope Kidz Club 2023-24 Registration Form

Description

Please Fix the Following