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Children's Ministry Registration (Sun & Wed)
Register here for:
Sunday morning Nursery, Preschool/Elementary SS
Wednesday evening Young Bereans/ Plugged In
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* Indicates required question
Registering Child for:
*
Sunday Morning
Wednesday Evening
Required
Child's Last Name
*
Your answer
Child's First Name
*
Your answer
Child's age or 2021-2022 academic grade
*
Under age 2
age 2
age 3
age 4
age 5 (Kindergarten)
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Child's Date of Birth
*
MM
/
DD
/
YYYY
Address
*
Your answer
Email
*
Your answer
Parents' First Names (last if different from child)
*
Your answer
Mom cell phone
*
Your answer
Dad cell phone
*
Your answer
Does your child have any food allergies or medical conditions?
*
Yes
No
If so, what are his/her food allergies/medical condition?
Your answer
Does your child have any special needs?
*
Yes
No
If so, what are they and how can we best accommodate you and your child?
Your answer
Is there anything else particular we should know about your child?
Your answer
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