2018-2019 Oak Hill Church Kids Activity Registration

If you have a child that is planning to be involved in any of our children's or student ministries, please fill out the form below. 

  If you have any questions, please call our church office at 332-1058 or email us at office@oakhillhumboldt.org

(fields marked with * are required)

Parent/Guardian Name *
Parent/Guardian Name
Address *
Address
Cell Phone *
Cell Phone
Secondary Phone Number
Secondary Phone Number
Medical Release *
As a parent and/or guardian, I do herewith authorize treatment under the direction of any licensed physician of the following minor(s) in the event of a medical emergency which, in the opinion of the attending physician, may endanger his or her life, cause disfigurement, physical impairment, or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me by phone at the number(s) listed below. The undersigned assumes the responsibility for any cost connected with such treatment and hereby releases Oak Hill Church from any liability therefore.
Child's Name *
Child's Name
Birthdate *
Birthdate
Child's Name
Child's Name
Birthdate
Birthdate
Child's Name
Child's Name
Birthdate
Birthdate
Child's Name
Child's Name
Birthdate
Birthdate
Child's Name
Child's Name
Birthdate
Birthdate
Child's Name
Child's Name
Birthdate
Birthdate
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Phone *
Emergency Contact Phone