2017-2018 Kids Groups Registration
Kids Groups Registration
(If Applicable)
(If Applicable)
In an emergency, if parents cannot be reached, please contact the above person.

Child 1

Please list any health concerns (medical, physical, developmental, or emotional conditions) relevant to the care of your child. (Allergies, arthritis, asthma, diabetes, etc.)

Child 2

Please list any health concerns (medical, physical, developmental, or emotional conditions) relevant to the care of your child. (Allergies, arthritis, asthma, diabetes, etc.)

Child 3

Please list any health concerns (medical, physical, developmental, or emotional conditions) relevant to the care of your child. (Allergies, arthritis, asthma, diabetes, etc.)

Child 4

Please list any health concerns (medical, physical, developmental, or emotional conditions) relevant to the care of your child. (Allergies, arthritis, asthma, diabetes, etc.)

Child 5

Please list any health concerns (medical, physical, developmental, or emotional conditions) relevant to the care of your child. (Allergies, arthritis, asthma, diabetes, etc.)

Video/Photo Release

give permission for videos and photos of my child(ren) to be produced on the various publications of Winkler Mennonite Brethren Church (WMBC). This includes the church website, newsletters, PowerPoint announcements, or other promotional material. I understand that these images can be viewed by anyone in the world, but no identifying information will be displayed without consent.

Email Permission

Would you like to receive email updates from Family Ministries Staff and/or your child(ren)’s Small Group Leader?

Purposes and Extent: WMBC is collecting and retaining this personal information for the purpose of enrolling your child(ren) in our programs, to assign the child(ren) to the appropriate class(es), to develop and nurture ongoing relationships with you and your child(ren), and to inform you of program updates and upcoming opportunities at WMBC. This information will be maintained permanently as it is a requirement of our insurance company and legal counsel. If you wish WMBC to limit the information collected, or to view your child(ren)’s information, please contact us.