New Family Form

Form for Guests with children attending service in Kid City.

Your name *

Email address *

Address *

Phone number *

Household members

So Kid City can best support your child, please indicate if your child(ren) exhibit any of the following behaviors?

Aggression (physical or object)

Elopement (Running away from where they should be)

Self-Harm (self injury behavior)

Non-Verbal

Other

Are there any medical conditions or allergies that we need to be made aware of? *

Photography Opt In or Out *

Center Point Church has a Photography Team that takes photos during the church services. These photos have the potential to be posted on our social media page. Please let us know if you would like to Opt In or Out. We do have a protocol in place for those who "Opt Out", which will require THE PARENT to place an orange sticker on their child's chest each service they attend. This makes it known to the Photography Team that they are "No Photo".

Can your child(ren) have goldfish for a snack? *

Goldfish are the ONLY snack offered in Kid City. If your child(ren) cannot have goldfish, please state their name and the reason.

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