Children and Youth Ministry Registration
 
Children and Youth Ministry Registration
Parent or Guardian Name
Your Email Address  * 
address
Emergency Contact (Name and Phone Number)
1st Child's Name
1st Child's DOB
1st Child's Grade Level for 2020/2021
2nd Child's Name
2nd Child's DOB
2nd Child's Grade Level for 2020/2021
3rd Child's Name
3rd Child's DOB
3rd Child's Grade Level for 2020/2021
4th Child's Name
4th Child's DOB
4th Child's Grade Level for 2020/2021
Are there any allergies or special needs your child has that we should be aware of?
 
 
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