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Children's Summer Registration
Children's Registration for 2012
Children's Ministries programs are for ages 3-years and potty trained to 5th grade
Child's name
*
Gender
*
Male
Female
Activity
*
All
Selected
Live BIG Sunday School, 11:00 am
VBS June 18-22
Sports Camp July 9-13
Dance Camp July 16-20
Club 45
Child's date of birth
*
Age
*
School grade for 2012/13
*
T-shirt size
X-small
small
medium
large
X-large
Parent name(s)
*
Address
*
City
*
State
*
Zip Code
*
Contact phone number
*
Contact Phone number
Home phone
Cell phone
Work phone
Emergency contact number
*
Emergency contact is
*
Parent
Relative
Friend
Email Address
*
Home church
*
Please type "none" if you have no church home.
Allergies or medical concerns
Permission to use child's picture in publications/website
*
Yes
No