Central Reformed Church - Student Education & Activity Registration Form

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Please complete the form below to register your student for any of the following Sunday morning or Wednesday evening activities:
* Sunday Morning
- Sunday School: 10:45am - 11:30am (3 years old - High School)
- Children and Worship: During Sunday Worship (4 years old - Kindergarten)
* Wednesday Evening
- LOGOS - Kids Ministries: 5:15pm - 7:00pm (Kindergarten - 6th grade)
- FOCUS - Jr. High Youth Group: 7:00pm - 8:00pm (7th & 8th grade)
- CHAOS - Sr. High Youth Group: 8:00pm - 9:00pm (9th grade - 12th grade)

First Name of Child 1 *

Last Name of Child 1 *

Birth Date (mm/dd/yyyy) *

YYYY

School Grade (Current) *

Child 1 will participate in: *

Children in Worship (4 years old - Kindergarten)

Pre-school (3 years old - Pre-school) Sunday School

Elementary (Kindergarten-6th grade) Sunday School

Junior High (7th-8th grade) Sunday School

Senior High (9th-12th grade) Sunday School

LOGOS (Kindergarten-6th grade) -Wednesday evenings 5:15-7:00pm

Junior High FOCUS (7th-8th grade) - Wednesday evenings 7:00-8:00pm

Senior High CHAOS (9th-12th grade) - Wednesday evenings 8:00-9:00pm

Required

Please list the child Insurance Policy Number. (if it is the same as your Family Insurance Number please leave blank)

Does this child have specific needs and/or allergies, that may need special attention, if needed?

Yes

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