CHILDREN'S MINISTRY REGISTRATION

Pre-School - 5th Grade

We ask all parents to register your children. Parents sign-in and sign-out your children in the Community Room. We will bring all the children together to have a closing song and blessing to end the Children’s Ministry hour.

* Required

Parent's First Name *

Last Name *

Parent's Email Address *

Home Address *

City *

State *

Zipcode/Postcode *

Phone Number *

1st Child's Name

Date of Birth

Gender -- Please select -- Male Female

Grade -- Please select -- PreK Kindergarten First Second Third Fourth Fifth

School

2nd Child's Name

Date of Birth

Gender -- Please select -- Male Female

Grade -- Please select -- PreK Kindergarten First Second Third Fourth Fifth

School

3rd Child's Name

Date of Birth

Gender -- Please select -- Male Female

Grade -- Please select -- PreK Kindergarten First Second Third Fourth Fifth

School

Emergency Contact Name

Emergency Cell Phone Number

Any Special Concerns

Contact me about volunteering Yes No

Enter Word Verification in box below *