Parent or Guardian

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email for Parent Newsletter

Phone

(###)

###

####

Children

Child 1

First Name

Last Name

Grade

Child 2

First Name

Last Name

Grade

Child 3

First Name

Last Name

Grade

Child 4

First Name

Last Name

Grade

Are there any special concerns or allergies we should know about?

Permission for photographs

We often photograph children and leaders for use on our Facebook page or for promotional purposes. May we take and use photographs of your child(ren) for these purposes?

YES

NO

2023 -24 Registration

Age 3 to 5th Grade

We are so excited to partner with you in teaching and training kids to know and follow Jesus!