New child registration Child’s Full Name * Parent/Guardian Name * Email Phone Numbers Home Work Cell * Address Street City State Zip Mailing Address (if different) Child Information Date of Birth * Last Grade Completed In School * PreKKindergartenFirst GradeSecond GradeThird GradeFourth GradeFifth GradeSixth GradeSeventh GradeEighth GradeNinth GradeTenth GradeEleventh GradeTwelfth GradeNursery (0-3) Allergies Allergy or other information we need to know. (If none, type N/A.) Emergency Contacts Name Phone Number Name Phone Number Dismissal Information * Who may pick up your child? Other Information Does your child attend Sunday School? If so, where? If your child is visiting our church with someone, who is he/she a guest of? Submit
