Skip to content
PRAYER AT 8:30 AM | WORSHIP SERVICE AT 9 AM | SUNDAY SCHOOL AT 10:30 AM
About Us
Our Story
What We Believe
Our Mission
Staff
Elders
Contact Us
Get Connected
Children
Youth
Adults
Missions
News
Village News
Calendar
Village Blog
Church Email Sign-Up
Sermons
Give
Menu Toggle
About Us
Menu Toggle
Our Story
What We Believe
Our Mission
Staff
Elders
Contact Us
Get Connected
Menu Toggle
Children
Youth
Adults
Missions
News
Menu Toggle
Village News
Calendar
Village Blog
Church Email Sign-Up
Sermons
Give
Sunday School and Nursery Registration
Please complete this form for all children in your household that are participating in any Child or Youth programs (Birth-12th grade) at Village Church. This registration needs to be completed by a parent or legal guardian of the child(ren) being registered. You may register up to four children from one family per registration. If you have more than four children, please complete another registration form.
Please enable JavaScript in your browser to complete this form.
–
Step
1
of 3
Parent/Guardian Information
Parent/Guardian Full Name
*
Parent/Guardian Cell Phone
*
Parent/Guardian Email
*
Parent/Guardian Information
Parent/Guardian Full Name
Parent/Guardian Cell Phone
Parent/Guardian Email
Participants Address
Participants Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Emergency Contact (Not a parent or guardian)
*
First
Last
Emergency Contact Phone
*
Next
First Student Participant
Student Name
*
First
Last
Birth Date (mm/dd/yyyy)
*
Student Grade
*
Nursery (Birth-2 Years Old)
PreK (3-5 Years Old)
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Programs that this student will participate in during 2021-2022 (Click all that apply)
*
Sunday Service Nursery (Birth-2 Years Old)
Sunday School Nursery (Birth-2 Years Old)
Sunday School (3 Years-5th Grade)
Sunday School (6th-12th Grade)
Wednesday Nursery (Birth-2 Years Old)
Nursery Release (check all that apply)
I give the Nursery staff permission to change my child’s diaper or assist in the bathroom.
I want to be notified to come change my child’s diaper or assist in the bathroom.
My child may have an age appropriate snack and water. (i.e. Cheerios, Graham Crackers, etc.)
Special Needs/Allergies/Medical Information
Second Student Participant
Student Name
First
Last
Birth Date (mm/dd/yyyy)
Student Grade
Nursery (Birth-2 Years Old)
PreK (3-5 Years Old)
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Programs that this student will participate in during 2021-2022 (Click all that apply)
Sunday Service Nursery (Birth-2 Years Old)
Sunday School Nursery (Birth-2 Years Old)
Sunday School (3 Years – 5th Grade)
Sunday School (6th-12th Grade)
Wednesday Nursery (Birth-2 Years Old)
Nursery Release (check all that apply)
I give the Nursery staff permission to change my child’s diaper or assist in the bathroom.
I want to be notified to come change my child’s diaper or assist in the bathroom.
My child may have an age appropriate snack and water. (i.e. Cheerios, Graham Crackers, etc.)
Special Needs/Allergies/Medical Information
Third Student Participant
Student Name
First
Last
Birth Date (mm/dd/yyyy)
Student Grade
Nursery (Birth-2 Years Old)
PreK (3-5 Years Old)
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Programs that this student will participate in during 2021-2022 (Click all that apply)
Sunday Service Nursery (Birth-2 Years Old)
Sunday School Nursery (Birth-2 Years Old)
Sunday School (3 Years – 5th Grade)
Sunday School (5th-12th Grade)
Wednesday Nursery (Birth-2 Years Old)
Nursery Release (check all that apply)
I give the Nursery staff permission to change my child’s diaper or assist in the bathroom.
I want to be notified to come change my child’s diaper or assist in the bathroom.
My child may have an age appropriate snack and water. (i.e. Cheerios, Graham Crackers, etc.)
Special Needs/Allergies/Medical Information
Fourth Student Participant
Student Name
First
Last
Birth Date (mm/dd/yyyy)
Student Grade
Nursery (Birth-2 Years Old)
PreK (3-5 Years Old)
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Programs that this student will participate in during 2021-2022 (Click all that apply)
Sunday Service Nursery (Birth-2 Years Old)
Sunday School Nursery (Birth-2 Years Old)
Sunday School (3 Years – 5th Grade)
Sunday School (6th-12th Grade)
Wednesday Nursery (Birth-2 Years Old)
Nursery Release (check all that apply)
I give the Nursery staff permission to change my child’s diaper or assist in the bathroom.
I want to be notified to come change my child’s diaper or assist in the bathroom.
My child may have an age appropriate snack and water. (i.e. Cheerios, Graham Crackers, etc.)
Special Needs/Allergies/Medical Information
Next
Photo Permission
I hereby grant Village Church the authorization to use and display photographs taken on our website, in the Village View, various digital social sites and/or other marketing for Village Church of the children listed below participating in church sponsored events. I certify that I am the parent and/or legal guardian of these children. I will make no monetary or other claim of any kind against Village Church or its directors, administrators, or employees, for the use of the photographs of these children on the church website.
Yes, photo permission granted
No, do NOT use any photos of my student(s)
Participation Agreement
I acknowledge that participation in the activity described above involves risk to the participant (and to the participant’s parents or guardians, if the participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness, exposure to infectious/communicable disease, bodily injury, death, emotional injury, personal injury, property damage, and financial damage. In consideration for the opportunity to participate in the activity described above (the “activity”), the participant (or parent/guardian if the participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the activity. The participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the activity or during transportation to and from the activity, as well as for any medical treatment rendered to the participant that is authorized by the sponsor or its agents, employees, volunteers, or any other representatives (collectively referred to as the “activity sponsor”). Further, the participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the activity sponsor for any injury arising directly or indirectly out of the described activity or transportation to and from the activity, whether such injury arises out of the negligence of the activity sponsor, the participant, or otherwise. If a dispute over this agreement or any claim for damages arises, the participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. If the participant (or parent/guardian) and the activity sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel for resolution in accordance with the rules of the American Arbitration Association.
Participation Agreement
*
I agree
Name of Parent/Guardian completing this form.
*
First
Last
Submit