2016-17 Children's Ministry Registration (One per Family)

If your child/ren will be attending WOW and/or Sunday School, please fill out this form as completely as possible. Thank you!

Warning!

This form cannot be submitted until an administrator completes the setup process to receive online payments.

CHILD #1 NAME:

*

Gender:

*

Please select one option.

Male Female

Register Child #1 for (check all that apply):

*

Please select all that apply.

Nursery Sunday School WOW

Allergies (incl. food - be specific):

If food allergies, can your child be in the same room with other children eating that food?

Please select one option.

Yes No

School:

*

Grade Level:

*

CHILD #2 NAME:

Gender:

Please select one option.

Male Female

Register Child #2 for (check all that apply):

Please select all that apply.

Nursery Sunday School WOW

Allergies (incl. food - be specific):

If food allergies, can your child be in the same room with other children eating that food?

Please select one option.

Yes No

School:

Grade Level:

CHILD #3 NAME:

Gender:

Please select one option.

Male Female

Register Child #3 for (check all that apply):

Please select all that apply.

Nursery Sunday School WOW

Allergies (incl. food - be specific):

If food allergies, can your child be in the same room with other children eating that food?

Please select one option.

Yes No

School

Grade Level:

Parents' Name

*

Email

*

Phone

*

Address

*

Emergency contact name & phone #:

*

WOW program fee per child is $35 and per family is $50.
Only an AUTHORIZED adult can pick up children.

Option

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

If your child/ren will be attending WOW and/or Sunday School, please fill out this form as completely as possible. Thank you!

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