Hive Information Sheet "*" indicates required fields Child's Name:* First Last Child's Home Address:* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Child's Birthday:*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Child's Age:*Select Grade0123456789101112131415161718Phone Number (if applicable):Who brings this child?*(check all that apply) Parent/Guardian 1 Parent/Guardian 2 Select AllParent/Guardian 1Name:* First Last Relationship to Child:* Phone #::*Cell #:Can we text?* Yes No Email: Use same address as child?* Yes No Parent/Guardian 1 Address:* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Parent/Guardian 2Name:* First Last Relationship to Child:* Phone:*Cell #:Can we text?* Yes No Email: Use same address as child?* Yes No Parent/Guardian 2 Address:* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Please list all adults that this child may be release to:* Does this child have any allergies?* Yes No Please list foods and environmental allergies:*Does this child require an epipen or other emergent care if they should come in contact with allergens?* Yes No Epipen or emergent care instructions:*Does this child have any medical concerns or special accomodations of any kind?* Yes No Please list any needs/accomidations:*Is there any other information you’d like to provide about this child to help us make their more enjoyable?* Yes No Share anything you think would be helpful for your child and us:*Media Release*At times we like to share photos and videos taken during worship or activities at The Hive with our families, our congregation, and our community to showcase how much fun it can be here. Do we have your permission to share photos and videos of this child on our HHUMC website, publications, and social media pages? Yes No Information Acknowledgment:*This information will remain confidential and be used by the staff at Hocking Hills UMC 13580 Maysville Williams Rd Logan, OH 43138 to serve you and this child to the best of our ability within the children’s ministry of the church. By signing below you are acknowledging your permission for the use of this information by the staff for that purpose. You are also agreeing to the following statements: I do not hold the church liable for personal injury while my child is in the care of HHUMC staff and volunteers. To the best of my knowledge, I have provided complete and accurate information regarding this child. Δ
