Child Emergency Form | Connection Church Inver Grove Heights

Child Information

First Name (Required)

Last Name (Required)

Birthday (Required)

Allergies or Medical Info

School Grade (Required)

Emergency Contact #1

First Name (Required)

Last Name (Required)

Your Phone Number (Required)

Email Address (Required)

Relationship to Child (Required)

Emergency Contact #2

First Name (Required)

Last Name (Required)

Phone Number (Required)

Email Address (Required)

Relationship to Child (Required)

Do you give permission for photographs of our child(ren) to be used for Connection Church's website and publications? *

Connection Church Inver Grove Heights