Wufoo
Southside Kid's Crew 2022-2023
Thank you for registering each of your children for activities & events at Southside UMC!
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Child Registration
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Release & Waiver of Liability
Child's Name
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First
Last
Child's Date of Birth
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DD
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Child's Age/Grade for 2022-2023
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PLEASE CHOOSE CHILD'S GRADE
Nursery: younger than 2 on 9/1/2022
PreK-2
PreK-3
PreK-4
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
School this Child Attends, Homeschooled or Nursery age?
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Address
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Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
United States
United Kingdom
Australia
Canada
France
New Zealand
India
Brazil
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Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua & Barbuda
Argentina
Armenia
Aruba
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia & Herzegovina
Botswana
Bouvet Island
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Caribbean Netherlands
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo - Brazzaville
Congo - Kinshasa
Cook Islands
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czechia
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard & McDonald Islands
Honduras
Hong Kong SAR China
Hungary
Iceland
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau SAR China
Republic of North Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Caledonia
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territories
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Samoa
San Marino
São Tomé & Príncipe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia & South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
St. Barthélemy
St. Helena
St. Kitts & Nevis
St. Lucia
St. Martin
St. Pierre & Miquelon
St. Vincent & Grenadines
Sudan
Suriname
Svalbard & Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Turks & Caicos Islands
Tuvalu
U.S. Outlying Islands
U.S. Virgin Islands
Uganda
Ukraine
United Arab Emirates
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wallis & Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
FOOD ALLERGIES and/or OTHER IMPORTANT MEDICAL INFO: Does your child have food allergies or other health or behavioral concerns that we should be made aware of so we can best care for them and provide a safe and healthy environment? If so, list details and you will be contacted. If this does not apply, please list "none." Thank you.
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Parent/Guardian’s Name (Primary Emergency Contact)
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First
Last
Parents Email
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Parent/ Guardian Mobile Phone Number
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Name of 2nd Parent or Alternate Emergency Contact
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First
Last
Contact Mobile Number for 2nd Parent or Alternate Emergency Contact
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Email for 2nd Parent or Alternate Emergency Contact
All are welcome! You do not need to be a member at Southside UMC to attend worship, classes or programs. We are glad you are here! Please tell us about your family so we can know and serve you better...
*
Please choose one of the below.
We are members at Southside UMC.
We are looking for a church home.
We have another church home but attend some Southside UMC programs & events.
We do not have a church home but will be attending one or more class, program or event at Southside UMC.
None of the above.
If you checked "None of the above" for the previous question or would just like to give us more information - please share here anything you think could help us know your family better. Thanks!
FOR CHILDREN, birth-5th Grade:
We need your help! Please let us know what groups, programs or classes the child you are registering is interested in attending:
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Child will attend Sunday Mornings
Child will attend Wednesday Nights
Child will attend Special Events or Seasonal Classes
Are there specific types of groups, programs, classes that you are interested in for your child? Please let us know here:
FOR ALL PARENTS:
We need your help! Please let us know if you are interested in learning more about opportunities to serve during any of the following:
*
Sunday Mornings
Wednesday Nights
Special Events or Seasonal Classes
Questions, input, ideas? Please share here!
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