KIDS Newcomer Cards & Check In Issue Cards

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FIRST TIME FAMILY Information Household Information Parent/Guardian: _________________________________________________ Cell #: ___________________________________

Relationship: _______________________

Email: ___________________________________________________

Address:_____________________________________________ City: ____________________________ Zip:___________ Parent/Guardian: _________________________________________________ Cell #: ___________________________________

Relationship: _______________________

Email: ___________________________________________________

Child Information Child:________________________________________ M / F

Age: _______

D.O.B. _____/_____/_____ Grade: _____

Child:________________________________________ M / F

Age: _______

D.O.B. _____/_____/_____ Grade: _____

Child:________________________________________ M / F

Age: _______

D.O.B. _____/_____/_____ Grade: _____

________________________________________________ Medical/Safety Alerts: __________________________________________________ Service:  Sat 5p Sun 9a Sun 10:30a Date:  ______________ How did you hear about us?

PHOTO CONSENT & Release Without compensation or other renumeration, now or in the future, I hereby give my consent to SeaCoast Grace Church its employees, affiliates, assigns and agents (the "Church", to use or not use my child ______________________________________________'s image, likeness and/or statements in its publications, and/or in its advertising or other media activities (including the Internet). This consent includes, but is not limited to: (a) Permission to interview, film, photograph, tape, or otherwise make a video reproduction of my child and/or record my voice; (b) Permission to use my child(s) name; and (c) Permission to use quotes from interview(s) (or excerpts of such quotes), film, photograph(s), tape(s), or reproduction(s) of my child's voice, in part or in whole, without limitation, in the Church's publications, or in newspapers, magazines and/or other print media, on television, radio and electronic media (including the Internet), in theatrical media and/or in mailings made for educational, awareness, and/or promotional purposes. I further agree that my child's participation in these activities confers upon me no rights to use, own or copyright any materials produced as a result of such participation. I release the Church from all liability which may arise from any and/or all claims by me or any third party in connection with my child's participation in such activities. This consent is given in perpetuity, and does not require prior approval by me. Child's Name:__________________________________________________________

Date: ________________________________

The below signed parent or legal guardian of the above-named minor child herby consents to and gives permission to the above on behalf of such minor child. Signature of Parent/Legal Guardian:______________________________________________________________________________________