2026 KidSpring Registration

Child Information

Name of Child

Nickname

Date of Birth

Grade

Caregiver Information

Name

Relationship to Child:

This address will receive a confirmation email

Cell Phone Number

Do you wish to receive Text message?: *By selecting “Yes” above, I am consenting to receive SMS messages from Breeze (Church Management System) regarding information and announcements for Wellspring United Methodist Church. I understand that message and data rates may apply and message frequency varies. I can opt out by responding STOP at any time. For support I can text HELP to 87447. Please review the Breeze Privacy Policy and Terms of Service available at breezechms.com for more details.

Yes No

Address

Name of Additional Individual for Pick Up/Drop Off

Relationship To Child

Additional Information

Does your child have any special needs, require accommodations or assistance or other information we should know about your child? Yes No

If Yes, please specify

Does your child have any allergies?

Yes No

If Yes, please list allergens

Is your child able to use the restroom independently?

Yes No

Diapering Needs: Do you wish us to: Change Diaper Inform Me

**I agree not to hold Wellspring United Methodist Church and its employees and members legally or financially liable for any illness, accident or injury to my child that may occur before, during or after any Nursery class. If my child should become ill or be injured and I cannot be contacted immediately, I agree that an employee of Wellspring United Methodist Church may, without liability, act in my stead in consenting to any medical treatment that he or she in good conscience deems to be in the best interest of my child. **I give my permission for any picture taken of my child to be used for promotional purposes.

I agree

Please Sign your Name:

Date

2026 KidSpring Registration

Description

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