Cultivate 2025-2026 Registration

Parent/Guardian Name(s)

This address will receive a confirmation email

Phone

Do you wish to receive text messages?

Yes No

*By selecting "Yes" above, I am consenting to receive SMS messages with information and/or announcements about Cultivate. I understand that message and data rates may apply and message frequency varies. I can opt out by responding STOP at any time.

Address

Name and phone number of Emergency Contact (if parent/guardian is unable to be reached.)

Child #1

Name

Birthdate

Grade

Allergies/special needs we should be aware of:

Child #2

Name

Birthdate

Grade

Allergies/special needs we should be aware of:

Child #3

Name

Birthdate

Grade

Allergies/special needs we should be aware of:

Child #4

Name

Birthdate

Grade

Allergies/special needs we should be aware of:

Child #5

Name

Birthdate

Grade

Allergies/medical needs we should be aware of:

Photo Release

I give MEFC permission to photograph my child(ren) and to use his/her/their photo(s) in the church’s digital and print communications. MEFC will never publish a child’s name or any other personal information in any of its publications.

yes no

Liability Release

I understand that there are risks involved in any church event, and I hereby release Milaca Evangelical Free Church and/or its volunteer workers from any and all liability for injury, loss, or damage to person or property that may occur during Cultivate at MEFC. By entering my name in the box below, I am providing my digital signature on this form.

Cultivate 2025-2026 Registration

Description

Please Fix the Following