Song & Sword Kids Registration

Parents or Guardians Names *

Address *

Phone number *

People authorized to pick up *

Childs First and Last Name *

Any allergies or special needs? If so please explain: *

Gender *

Birthdate *

Grade

I give permission for Song & Sword to take photographs and / or video of my child. *

I grant full rights to use the images resulting from the photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes.