Discovery Land 2017-2018

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Child's Information

Household Information

Parent's Information

Parental Consent

I/We, the undersigned, parent(s) or legal guardian of the minor listed above, do hereby give permission for Alliance Church of Menomonie to take and/or use photographs, voice, video, or digital tapes of my child for promotional/informational materials.
I/We understand that said minor should not attend activities when knowingly ill or recently exposed to a contagious disease. If said minor becomes ill or injured while in the care or under the supervision of Alliance Church of Menomonie, I authorize said minor to receive first aid by any of its staff or volunteers.

Description

Please fill out this form and click submit. Please fill out one per child.

Thank you for helping us care for your children!