Crossroads Kids New Family Registration-Manitowoc • Crossroads Community Church

Family Information

Parents or guardians, please provide your contact info below. (once you enter your information and click on "Add Children", you'll be prompted to enter each child's information below.)

Parents, Please check your relationship to the child(ren) below (*For the actual child just choose "CHILD" please) *

First Name *

Last Name *

Email Address *

Tip: If you don't have one, type in abc@123.com.

Phone Number *

Date of Birth (for CHILD only)

School Grade (for CHILD only)

Allergy (for CHILD only)

Home Address

Home Address *

Home City *

Home State *

Home Zip Code *

Church Location

Choose what church campus you are attending.

Locations *

Crossroads Community Church Manitowoc

Crossroads Community Church Sheboygan

Other

*Photo Release

With your permission, we would like to be able to include your child(ren)’s picture in our e-newsletter, church website, Facebook, or other form of advertisement. Please check one of the options below to either grant Crossroads Community Church permission to use you and/or your child’s photo, OR deny permission of your child(ren)'s picture being used.

If you are granting access, please read the following statement:

I hereby grant permission to Crossroads Community Church to use my child(ren)’s photo on their website, Facebook, or in other official publications, and I acknowledge that Crossroads Community Church’s right to crop or treat the photo at their discretion.

I also understand that once my image is posted on the website or newsletter, the image can be downloaded. Therefore, I agree that Crossroads Community Church is not held responsible for any such occurrences.

With your permission, we would like to be able to include your child(ren)’s picture in our e-newsletter, church website, Facebook, or other form of advertisement. Please sign this release form to grant Crossroads Community Church permission to use you and/or your child’s photo.