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Wednesday Kids ministries will begin on August 28th from 6:30-7:30pm. Please fill out the form to register your child.
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Indicates required field
Name
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First
Last
Child's Grade
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18 months 3 year old "PUGGLES"
4 year old "CUBBIES"
Kindergarten "EXPLORERS"
1st Grade "EXPLORERS"
2nd Grade "EXPLORERS"
3rd Grade "EXPLORERS"
4th Grade "EXPLORERS"
5th Grade "EXPLORERS"
Parent/Guardian Name
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Cell Phone Number
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Address
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City
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State
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Zip Code
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Parent/Guardian Email
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Child's Food Allergies
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Emergency Contact Name
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Emergency Contact Phone #
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Emergency Contact Relationship to Child
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Other Allergies or Medical Conditions
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May we have permission to photograph and/or video your child for use in church publications?
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Yes, you have permission to photograph/video my child.
No, I do not give permission to photograph/video my child.
Submit