2021-2022 Ignite! Registration Form
Please fill out this form and click submit.
Name of Child
*
Date of Birth of Child
*
Grade of Child
*
Please select one option.
2nd
3rd
4th
5th
Name(s) of Parent/Guardian
*
Preferred Email
*
This address will receive a confirmation email
Phone #1
*
Phone #2
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Emergency Contact Name & Phone
How will your child return home from Ignite?
*
Does Ignite staff and adults have permission to transport your child to off-site events in private vehicles?
*
Please select one option.
Yes
No
Does your child have any food allergies or special concerns?
*
Photo Release - Does Waverly First United Methodist Church have your permission to use photographs taken of your child/ren for informational and publicity purposes including, but not limited to, press releases, bulletins, internet postings, advertisements or other legitimate purposes for and on behalf of the Waverly First United Methodist Church and it's ministries. I Understand that my selection on this release grants permission to the church to use any photographs taken; however, it does not allow Waverly First United Methodist Church to release any personal information including, but not limited to, my child's name and/or address.
*
Please select one option.
Yes, I give permission.
No, I do not give permission.
Anything else we should know?
Would you like to volunteer to serve in Children's Ministries at Waverly First United Methodist Church? All volunteers who work with children and youth must have a background check and receive Safe Gatherings certification.
Please select one option.
Yes, I would like to volunteer for Children's Ministry at Waverly First. Please contact me.
No, I would not like to volunteer for Children's Ministry at Waverly First.
Parent/Guardian Signature - (By typing your name you certify that the information included in this form is accurate and up to date. Please inform us of any changes in information.) As the parent or legal guardian, I give my consent for my child to attend and participate in all activities provided by Ignite! of Waverly First United Methodist Church.
*
Submit
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