Gulf Breeze Presbyterian Church

YOU DO NOT NEED TO FILL THIS OUT IF YOUR CHILD PATICIPATED IN THE FALL.

PLEASE LET US KNOW OF ANY CHANGES!

Gulf Breeze Presbyterian Church

Kidz Program 2015 - 3:00 pm – 5:00

Garden Club – 4:30 – 5:30pm______Check here if interested in the Junior Garden Club

TRANSPORTATION

CHILD’S NAME BIRTHDATE SCHOOL/DAYCAREGRADE NEEDED from SCHOOL

______

***If transportation is needed to Kidz, please complete transportation form.

Please list any allergies/special needs/medications ______

PARENTS: ______

HOME ADDRESS: ______

STREET ZIP

Cell PHONE: ______HOME CHURCH: ______

E-MAIL: ______

______I AM WILLING TO VOLUNTEER AT THE Kidz program from 3:00 – 4:00.

______I AM WILLING TO VOLUNTEER AT THE Kidz program from 4:00 – 5:00.

Please list dates and times that you can help.______

IN CASE OF EMERGENCY

Please list alternate phone numbers and adults in case of emergency during the Kidz program (Wednesdays

Approximately 3:00 – 5:00p.m.) Please call the church 932-3625 when your child is not attending.

PARENT: ______Work______Cell/Pager______

Alternate adults to contact (please list at least one):

NAME: ______Work______Cell/Pager______

PHYSICIAN: ______PHONE:______

I ______, hereby give my consent for a representative of Gulf Breeze Presbyterian

Church to seek medical attention for my above-named child(ren) in the event I cannot be reached.

Signed______Date______

I give GBPC permission to post pictures on the church website.______

Send a note if you have made reservations for our 5:30 Wednesday night dinner beginning 9/10 and we will watch your children until 5:30. If you have questions about Kidz, please call Patty Arnett at the Church office (932-3625)

KIDZ TRANSPORTATION FORM

GULF BREEZE PRESBYTERIAN CHURCH

100 Andrew Jackson Trail

Gulf Breeze, FL 32561

932-3625

I,______, herby give my permission for mychild,______to be released to a representative of Gulf Breeze Presbyterian Church in order for them to attend the Kidz program on scheduled Wednesday afternoons during the 2015 school year.

Please check appropriate location:

__Gulf Breeze Elementary School (934-5185) __Oriole Beach Elementary School 934-5160Picked up by Santa Rosa county school bus Picked up in Church van

If other transportation is needed, contact Patty Arnett at the Church office (932-3625).

Please return this portion of the form to the

school or daycare.

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KIDZ TRANSPORTATION FORM

GULF BREEZE PRESBYTERIAN CHURCH

100 Andrew Jackson Trail

Gulf Breeze, FL

932-3625

Please check appropriate location:

____Gulf Breeze Elementary School (934-5185) ____Oriole Beach Elementary School(934-5160)

Picked up by Santa Rosa county school bus Picked up in Church van

If other transportation is needed, contact Patty Arnett at the Church office (932-3625).

Please return this portion of the form to the

Church.

GBPC Good Behavior Covenant

We are excited about this year’s Kidzprogram and our New Children’s Choir. To help each other learn and share in the activities, you are asked to commit to these rules for appropriate and respectful behavior:

 I commit to treating my leaders with respect.
 I commit to treating others as I would like to be treated. I will keep my hands and feet to myself. I will be quiet when asked to do so.
 I commit to being a helpful and courteous member of Kidz.
 I commit to beinga good steward of our GBPC property.
 I commit to learning about our awesome God!

______

Parent signaturedate

______

Child signaturedate

______

Child signature date