Please complete the form below (One FORM per CHILD)

2024 Fall W.K.S. Registration Form

Child's Information

First Name

Last Name

Shirt Size

Grade

Date Of Birth

YYYY

Child's Age

Child’s Gender:

Male

Female

Name of Parent(s)

First Name

Last Name

Cell Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Church

Are parent(s) helping with WKS?

Yes

If yes, where are they helping?

Worship Kids Style (WKS) Waiver: I, the under signed parent/guardian of the above named child do hereby consent to his/her participation in WKS at Cornerstone Community Church (C3). I agree to waive and release (C3) and its volunteers from all claims for damages that may arise, as a result of my child’s participation in WKS. I am aware that the above named child may appear in a photographs, or videos, taken by WKS staff, and that photographs or videos may be used. I acknowledge and confirm that I have read this entire document before typing my name below.

Please type your name as your signature.

Type Today's Date

YYYY

In Case of Emergency, Please Contact

First Name

Last Name

Phone

(###)

###

####

Relationship to Child

Allergies or Other Medical Conditions

(Please be Specific)

Would you like to Volunteer?

Looking forward to a great WKS this Fall!!

This will be forwarded to our WKS Director Julie.

Name

First Name

Last Name

Phone Number

(###)

###

####

Message

Any questions let us know…

Looking forward to a great WKS this Fall!!

Questions will be forwarded to our WKS Director Julie.

Name

First Name

Last Name

Subject

Message

Please complete the form below (One FORM per CHILD)

2024 Fall W.K.S. Registration Form

Would you like to Volunteer?

Any questions let us know…

(760) 356-1061 • CONTACT@C3HOLTVILLE.ORG