Registration is now open.
Click here to start!
 
We'll start by registering your grade school child(ren).
Please complete the following questions for each child.

 
Child 1

 
First name: *

 
Last name: *

 
Gender: *


 
Age: *


 
Date of birth *

 
Does this child have any medical and/or learning conditions that we need to be aware of? *

     
 
Check the relevant boxes. *


 
Please tell us what we need to know.

Examples:  allergy to peanuts; in a wheelchair ...
 
Do you have additional grade school children you'd like to register? *

     
 
Child 2:

 
First name: *

 
Last name: *

 
Gender: *


 
Age: *


 
Date of birth *

 
Does this child have any medical and/or learning conditions that we need to be aware of? *

     
 
Check the relevant boxes. *


 
Please tell us what we need to know.

Examples:  allergy to peanuts; in a wheelchair ...
 
Do you have additional grade school children you'd like to register? *

     
 
Child 3:

 
First name: *

 
Last name: *

 
Gender: *


 
Age: *


 
Date of birth *

 
Does this child have any medical and/or learning conditions that we need to be aware of? *

     
 
Check the relevant boxes. *


 
Please tell us what we need to know.

Examples:  allergy to peanuts; in a wheelchair ...
 
Do you have additional grade school children you'd like to register? *

     
 
Child 4:

 
First name: *

 
Last name: *

 
Gender: *


 
Age: *


 
Date of birth *

 
Does this child have any medical and/or learning conditions that we need to be aware of? *

     
 
Check the relevant boxes. *


 
Please tell us what we need to know.

Examples:  allergy to peanuts; in a wheelchair ...
 
Great!  Now let's gather some info about you.

 
What is your...

 
First name? *

 
Last name? *

 
Phone number? *

Write the number without dashes (2538598998).
 
Mailing address? *

Apt/House #, street, city & zipcode
 
Is this address the same for the child(ren) you are registering? *

     
 
Please enter the child(ren)'s mailing address *

Apt/House #, street, city & zipcode
 
Do you wish to register for the Adult Class? *

Registration is required to attend
     
 
Do you have a spouse or significant other you'd like to register for the Adult Class? *

Registration is required to attend.
     
 
Please give their first & last names: *

 
OK. That takes care of grade schoolers and grown-ups. Now to preschoolers.

 
Do you have a preschooler (ages: 3 and 4 years old) to register for childcare during this event? *

     
 
What is their

 
First name: *

 
Last name: *

 
Gender: *


 
Date of birth: *

 
Does this child have any medical and/or learning conditions that we need to be aware of? *

     
 
Check the relevant boxes. *


 
Please tell us what we need to know. *

Examples:  allergy to peanuts; in a wheelchair ...
 
Do you have additional preschoolers (ages 3 and 4 years old) to register for childcare during this event? *

     
 
Childcare registration for preschool child 2

 
 
First name: *

 
Last name: *

 
Gender: *


 
Date of birth: *

 
Does this child have any medical and/or learning conditions that we need to be aware of? *

     
 
Check the relevant boxes. *


 
Please tell us what we need to know. *

Examples:  allergy to peanuts; in a wheelchair ...
 
Would you like to register your family members for the dinners? *

     
 
How many of your family members will be attending the dinners?

Registration is required for attendance.
 
Number of grown-ups? *

A grown-up must be present with child(ren) during the dinner.
 
Number of kids? *

 
Do you have a church you call home? *

     
 
What is the name of the church?

 
How did you FIRST hear about this event? *


 
The last but ESSENTIAL step! 
Please review and complete the following medical consent form and photography waiver.

 
We occasionally use photos of people and groups on the church website or in publications.

I hereby grant permission to New Hope Presbyterian Church in Kent, WA, to use photograph(s) of the child(ren) named on this registration form on its website or in other official church printed publications without further consideration. I acknowledge the church has the right to crop or treat the photograph(s) at its discretion. I also acknowledge that the church may choose not to use my photograph(s) at this time, but may do so at its own discretion at a later date. Therefore, I agree to indemnify and hold harmless the church, pastors, staff, and its members and designees from any claims arising out of the use of my photograph(s). *

You may rescind this permission at any time by sending a signed letter to New Hope Presbyterian Church, Attn: Children's Ministry, 19800 108th Ave SE, Kent, WA 98031.

 
In case of medical emergency, I, {{answer_GPdw}}{{answer_gQVn}}, understand that every reasonable effort will be made to contact me. In the event that I cannot be reached, I hereby authorize and consent to medical, surgical and hospital care, treatment and procedures to be performed for my child by a licensed physician or hospital when deemed immediately necessary or advisable by the physician to safeguard my child’s health. I waive my right of informed consent to such treatment. Further, the undersigned expressly agrees to hold harmless New Hope Presbyterian Church, its employees and agents, for any injury to the minor or damage to their personal property which may be incurred by or as a result of their participation. I acknowledge that I have read and accept this statement. *


 
Who can we contact in the event of an emergency? *

someone other than parent
 
What is their phone number? *

Write the number without dashes (2538598998).
 
Who is your child(ren)'s doctor? *

first & last name
 
And their phone number(s)? *

Write the number without dashes (2538598998).
 
Are there any known legal conditions for any of the children you have registered for this event? *

     
 
Please explain what we need to know. *

Done! Thank you for registering for Kids' Week 2017! You will receive an email confirming your registration. For more information about what's happening at New Hope, check out our website at www.newhopekent.org. See you on July 12-14!
New Hope
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