Children’s Ministries Registration 2017-2018

Family Information
Family Name	*
Parents' Names	*
Street Address	*
City	*
Zip Code	*
Cell Phone #	*
Home Phone #
Email Address	*
Most frequently attended service	*  Sat @ 67:45 am9:00 am11:15 am
We plan for our kids to attend Sunday School during the 10:15 Education hour	*  No Yes
How would you like to help us occasionally?	---Preschool VolunteerElementary Service Helper (9:00 or 11:15)Education Hour HelperHospitality Team (Snacks, Supplies, & Set-up)
Child 1
Child 1 Name	*
Child 1 Birthdate (MM/DD/YYYY)	*
Child 1 Gender	*  MaleFemale
Child 1 Age/Grade	*  0-1 year1 year2 years3 years4 years5 yearsKindergarten1st grade2nd grade3rd grade4th grade5th grade
Notes for Child 1 (Allergies, special needs, etc.)
Child 2
Child 2 Name
Child 2 Birthdate (MM/DD/YYYY)
Child 2 Gender	MaleFemale
Child 2 Age/Grade	0-1 year1 year2 years3 years4 years5 yearsKindergarten1st grade2nd grade3rd grade4th grade5th grade
Notes for Child 2 (Allergies, special needs, etc.)
Child 3
Child 3 Name
Child 3 Birthdate (MM/DD/YYYY)
Child 3 Gender	MaleFemale
Child 3 Age/Grade	0-1 year1 year2 years3 years4 years5 yearsKindergarten1st grade2nd grade3rd grade4th grade5th grade
Notes for Child 3 (Allergies, special needs, etc.)
Child 4
Child 4 Name
Child 4 Birthdate (MM/DD/YYYY)
Child 4 Gender	MaleFemale
Child 4 Age/Grade	0-1 year1 year2 years3 years4 years5 yearsKindergarten1st grade2nd grade3rd grade4th grade5th grade
Notes for Child 4 (Allergies, special needs, etc.)
Child 5
Child 5 Name
Child 5 Birthdate (MM/DD/YYYY)
Child 5 Gender	MaleFemale
Child 5 Age/Grade	0-1 year1 year2 years3 years4 years5 yearsKindergarten1st grade2nd grade3rd grade4th grade5th grade
Notes for Child 5 (Allergies, special needs, etc.)
Other
Additional comments/questions/concerns
Email Confirmation
Your Email Address	*