Child Registration

Please tell us about your child

Child's Name:

Child's Name

Child's age:

Child's age

Child's Grade if in school:


Child's birthdate:

Child's age

Child's sex:

Is the child alergic to anything?

Is there anything else the workers should know?

Please select programs for which the child is being registered:

Provide an emergency contact for the child.  

Parent or Guardian Information

Parent Address

NOTE:  Unless you inform us not to ever use a picture of your child(ren), they may appear in activity pictures on the church’s website or Facebook page.


After submission, this form will reload to allow registration of additional children.  

Use the top or footer menu to navigate to another location in the site.  

Thank you for registering online.