Evangel Kids Family Info Form

Thank you for choosing to spend your Sunday with us.

NOTE: Parent/Guardian, please fill out YOUR information below first. Under Household Members, click on "Add Child" to add each of your children to the household before clicking "Submit".

Your name *

Email address *

Phone number *

Gender *

Birthday *

Address

Primary campus *

Photo and Video Release *

I, the undersigned parent or legal guardian of the child(ren) listed in my household, hereby grant Evangel Church permission to the rights of my child's image, likeness and sound of their voice as recorded on audio or videotape without payment or any consideration. I understand their image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein their likeness appears.

Yes, I give consent.

No, I do NOT give consent.

Consent to Medical Treatment

I, the undersigned parent or legal guardian of the child(ren) listed in my household, do grant permission and consent for said child to receive emergency medical care if: 1) such care is deemed necessary by the caregiver having custody of my child at Evangel Church 2) the proposed medical treatment or procedures are immediately or imminently necessary and any delay occasioned by an attempt to obtain my personal consent would reasonably jeopardize the life, health, or well-being of the child affected or 3) I cannot be personally contacted.

Electronic Signature *

By typing my name below, I am providing an electronic signature on this form and agreeing to all of the aforementioned statements above confirming that I have read and understood the above statements.

Date of Signature *

Before clicking submit, please add your child(ren) by selecting, "Add Child" below.

Household members

Please be sure to fill out this information for each person in your household.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.