Registration Form

Child's Full Name:

Nickname:

Child's Age: Birthday: Grade in School:

Address:

City, State & Zip Code:

Home: Cell:

Your Email:

Allergies or other conditions we should be aware of.

Emergency contact (Name & Phone #):

Additional information you would like us to know about your child.

Parent or Guardian Contacting Information

Parent's (Guardian's) full name:

Address:

City, State & Zip Code:

Home: Cell: Work:

Your Email:



Parent's (Guardian's) full name:

Address:

City, State & Zip Code:

Home: Cell: Work:

Your Email:

Others allowed to pick up or drop off child:

Echo Hill Presbyterian Church Photograph Release Form

Minor children need to have parent's or guardian's permission for EHPC to use any picture in which they appear on the EHPC web site or in other materials depicting minor children in Sunday School or Youth activities. If you mark yes, the undersigned party gives permission for Echo Hill Presbyterian Church to use such pictures. When signing for your minor child, put child's name in parentheses behind your signature. If you do not want your children's pictures on the Web Site or other church materials, please mark no on the space provided and sign your name.

Please note that if you select no, we may have to ask your child to not be included in any photography being done. Please explain this in advance to your child. Thank you.

Echo Hill Presbyterian Church has my permission to use any or all pictures in which my child appears for the Echo Hill Presbyterian Church Web Site.

Child's Name:  Yes  No

Signature of Parent/Guardian: Date:

Child Safety Policy

Please review our Child Protection Policy on our website: at

Child Protection Policy

Thank you for completing this form.

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