Youth/Children Ministry Registration

Parent/Guardian Name/s *

Phone #'s *

Mailing Address

Email Address

First Name

Last Name

Birthdate

Grade

Check all your child will be involved in:

Other:

First Name

Last Name

Birthdate

Grade

Check all your child will be involved in:

Other:

First Name

Last Name

Birthdate

Grade

Check all your child will be involved in:

Other:

First Name

Last Name

Birthdate

Grade

Check all your child will be involved in:

Other:

First Name

Last Name

Birthdate

Grade

Circle all your child will be involved in:

Other:

First Name

Last Name

Birthdate

Grade

Check all your child will be involved in:

Other