Child Registration Form

To register your child for Children's Ministry prior to attending, please fill out this form and click submit.

A separate form is needed for each child to best integrate with our software.
An adult's name and phone number is required for each entry (for emergency contact purposes.)

Family Information

Email

*

This address will receive a confirmation email

Cell Phone

*

Address

Parent(s)/Guardian(s) Name(s)

*

Additional Adult's email(s) and /or cell#'s

Parent(s)/Guardian(s) Birthdate(s)

Child Information

Name

*

Gender

*

Please select one option.

Male Female

Birthdate

Age Level/Grade

Please select one option.

Birth-18 months 18 months - 3 years 3 years old 4-5 years old Kindergarten 1st grade 2nd grade 3rd grade 4th grade 5th grade

Allergies / Disabilities

Additional Notes

Description

To register your child for Children's Ministry prior to attending, please fill out this form and click submit.

Please Fix the Following

Close