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Children's ministry check-in and registration form

One form per child, filled in by a parent or guardian before or at the first check-in. Keep the completed form where only the kids ministry team can see it. Confidential once filled in.

Date receivedRoom / classEntered in system bySecurity code (if used)

1. Child

Child's full name

Name they go by

Date of birth

Grade / age group

Home address

Siblings also registered

2. Parent or guardian

Parent or guardian 1: name

Relationship to child

Mobile phone

Parent or guardian 2: name

Relationship to child

Mobile phone

Where you will be during the service (room, seat area, or "serving")

Best way to reach you during the service (text / usher / screen number)

3. Emergency contacts (other than the parents above)

Name	Relationship	Phone

4. Allergies and medical notes

No known allergies
Food allergy (list below, and say how serious: mild / needs medication / epinephrine pen)
Other allergy (insect, medication, latex, other)
Medical condition the team should know about (asthma, epilepsy, diabetes, other)
Carries medication: what, where it is kept, and who may give it
Additional needs: anything that helps your child settle, communicate or take part

Details

Doctor or clinic name and phone

Insurance or health number (optional, only if your church asks for it)

5. Authorized pickup

Only the people listed here may collect this child. A volunteer will release the child only to an adult on this list who presents the matching pickup tag or code. Tell the kids ministry lead whenever this list changes.

Name	Relationship	Phone

Custody or safety notes

Is there anyone who must not collect this child? Any court order we should know about? (Seen by the kids ministry lead only.)

6. Photo and media consent

Yes, you may use photos or video of my child in church publications, slides, the church website and the church's social media.
Yes, but only inside the church (printed in the building, shown on Sunday), never online.
No, please do not photograph or film my child.

7. Permission and signature

I am the parent or legal guardian of the child named above and the information on this form is correct.
I give permission for my child to take part in the children's ministry activities on church premises.
In an emergency, if I cannot be reached, I authorize the leaders to seek medical treatment for my child.
I understand this form is kept confidentially by the kids ministry team and used only for my child's care and safety.
I will tell the team when any of the information above changes.

Parent or guardian signature

Date

Print name

Reviewed by (church)

Doing this in ChurchoryChurchory Kids collects the same information through a family intake link parents complete before Sunday, without an account; shows allergy and note flags in a live room-by-room view; and prints a name label and a matching pickup code at check-in. See Kids check-in.

A free template from Churchory, church management software for small and mid-size churches. Use it, change it and share it; no sign-up needed. It is general guidance, not legal advice: check your own denomination's, insurer's and local requirements, including data protection rules for the information you keep. More templates: churchory.com/resources/templates.