Emerg. Card Child5

Sunday School Emergency Card

* Indicates required field

Child's Name *

First

Last

Grade *

Parent's Name *

First

Last

Phone Number to be reached at During Sunday School *

Parent's Email *

Food Allergies *

Other Information about Your Child we Should Know *

I give permission and consent to allow photographs, video and interviews to be taken during the Sunday School year. I further give consent that any such images or interviews may be published and used to illustrate and promote CCC and its ministries.

Choosing yes is the same as your signature *

Yes No

Date *

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