Forms:




Orchard Crest Baptist Church Children/Youth Dept Emergency Form

(one form per child)


Child's Full Name: 

Child's Birthday:

School Grade: 

Gender (Male/Female): 

Church Member (yes/no): 

Saved (date): 

Baptized (date): 

Parent/Gaurdian Name: 

Parent/Guardian Address: 

Parent/Guardian Email: 

Parent/Guardian Phone Number: 

Allergies/Health Problems: 
 I authorize medical treatment for my child in case of accident/illness if parent/guardian can't be reached/located or an emergency situation should arise.
Hospital Choice: 
 I authorize my child/youth photo to be used on social media, church advertising, webpage etc.
Church Van Pickup (yes/no):      Sunday    Wednesday 

Other emergency contact/authorized pickup:
1:   Name:     Phone Number: 
     Address: 
2:  Name:      Phone Number: 
     Address: 
3:  Name:      Phone Number: 
     Address: 

Parent/Guardian Signature:      Date: 



 




      ...a loving church