SPARK Registration form
Sign in to Google to save your progress. Learn more
SPARK at St. John's, Kittanning, ...Dinner, Epic Bible Stories, Crafts, Games, and fun for kids PreK-6th Grade!
Child's First Name
 *
Child's Last Name
 *
Nickname, if any
Parent/ Guardian First and Last Name
 *
Second Parent/Guardian First and Last Name
Child's birthday
 *
MM
/
DD
/
YYYY
Grade
Address
 *
Parent/Guardian Phone
*
Parent Guardian #2 Phone
 *
Emergency Contact #1 Name and Phone
 *
Emergency Contact #2 Name and Phone
 *
Allergies, Medical Needs, or any other concerns or issues that we need to be aware of
 *
Who will be dropping off/ picking up your child to Spark?
 *
Relationship of those dropping/off picking up.
 *
Parent/Guardian Email
 *
Home Congregation
Best way to contact you for event updates
 *
All updates for SPARK, announcements, cancellations, etc. will be on the SPARK facebook page, as well as a text message that I can sign up for.
Clear selection
Please text SPARK to 7242765321 to receive reminders, updates and announcements. Please check yes or no, if you have signed up for messages.
*

In case of a serious emergency and I cannot be reached, I give permission for St. John’s or Children’s Hour Staff to seek appropriate, professional medical attention for my child.

 *
I give St. John's permission to advertise our program with photos of my child.
*
Please read Code of Conduct for St. Johns Kittanning, and sign and date.We welcome your child into a safe, caring learning environment here at St. John’s, Kittanning.  A place to create fun, faith-filled experiences and friendships. Please be aware of the following:

1.  Parent/Guardian is responsible for their child’s behavior while attending SPARK.

2.  Should your child be exhibiting behaviors which are disruptive to the group, you may be asked to remove the child until the behavior improves or the duration of the session.

3.  If your child exhibits any behavior that places others at risk, you will be asked to leave at the discretion of the SPARK volunteers.  Your continued participation will be at the sole discretion of St. John's volunteers and Director.

4.  As a parent/guardian you understand your conduct, behavior and attire also must be in keeping with our values as a Christian Organization.

By digitally signing this form, I understand that my child’s participation in the SPARK program at St. John's Kittanning, is dependent on my compliance with the Code of Conduct.

Please sign and date the field below:

*
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms