CHILDREN'S REGISTRATION

Register your child here for weekend Communities and/or Tuesday Clubs. Please register one child at a time. Note: There is a separate registration form if you'd like your child to be involved in the children's choirs.
.................................................................................................
* means required field.

Child Information:

*First name:   *Last name:

*Birth date: Month   Day Year

*Grade:   *Gender:

List any allergies:


List any discipline concerns:

................................................................................................

Parent/Guardian Information:

*Father/Male or Sole Guardian:

Street Address:

City:   State:   Zip:

*Phone:   check here if this is a cell phone

E-mail address:

Check here if you would like to receive the Children's Ministry weekly email highlights.


Mother/Female Guardian:

Phone number:    check here if this is a cell phone

E-mail address:

 check here if you would like to receive the Children's Ministry weekly email highlights.

................................................................................................

Emergency Contact Information:

*Name:

*Relationship to child:

*Phone: 

Alternate phone:

................................................................................................

Children's Community:

Please indicate the primary time your child will attend the children's community:

If your preschool child will attend a second hour, please indicate which one below: 

Weekday Activities:

Please note the fees associated with the weekday activities:
Young Explorers (Ages 4-5) / annual membership $25
*Must be 4 years old by April 1, 2008.
P31 (Grade 1-Grade5) / annual membership: $25
Boy's Brigade (Grade 1-Grade 5) / annual membership $25

Choose an activity:


If you are signing your child up for a weekday activity, please print this page, before you click submit and turn in it in with your payment to the payment box located at the Children's Welcome Desk. Scholarships are available. Please contact the Valley Children's Ministry for an application, 673.6826 x117

 Please check here if you would like to volunteer in the Children's Ministry and we will contact you.

Visitors