If different from above, enter the name you wish to have your child addressed by their leaders below:
Enter grade below for the 2022/23 school year:
School
*
Select Option
Not in School
Blumenfeld School
Border Valley School (Reinland)
Ecole Elmwood School (Altona)
Emerado Centennial School
Hochfeld School
Homeschooled
J.R. Walkof School
Manitou Elementary School
Maple Leaf School (Morden)
Miami School
Minnewasta School (Morden)
Ecole Morden Middle School
Parkland Elementary School
Pineridge Elementary School
Plum Coulee School
Prairie Dale School (Schanzenfeld)
Prairie Crossroads School
Roland School
Rosenfeld School
Southwood School (Schanzenfeld)
Valley Mennonite Academy (Chortitz)
W.C. Miller Collegiate (Altona)
École West Park School (Altona)
Winkler Elementary School
Other (please indicate below)
Parent/Guardian Information
Please enter your phone numbers below with dashes, ex. 000-000-0000
Emergency Contact (if Parents/Guardians are not available)
Authorization & Medical Consent
If you answered yes, please specify below:
We (parent/guardian) allow WMBC Ministry staff and volunteers to provide medical needs (ex. apply a bandaid, call medical help if needed) when your child is in our care AND the parent/guardian is not available.
I give permission for videos and photos of my child to be used in WMBC for the website, newsletters, digital announcement, social media, and other promotional material. I agree they can be viewed by anyone but no identifying information will be displayed without consent.
Video/Photo Release
*
Select Option
I agree
Do not use my childs videos/photos
Would you like to receive email updates from Family Ministries Staff and/or your child's Small Group Leader?
WMBC is collecting and retaining this info in order to enroll your child in our programs, assign your child to appropriate small groups, and to inform you of updates or upcoming opportunities at WMBC. If you wish to limit the information please contact us.
I have read, understood, and agree with the above and sign it to cover all children's program activities for the program year effective as stated below. A separate Informed Letter of Consent will be sent home for off-site activities and activities of elevated risk.