Children’s Church Registration | PUMC

Children’s Church Registration

Fields marked with an * are required

Child's Full Name *

Child's Preferred Nick Name *

Date of Birth *

Gender

Current Grade *

Address *

Mother's Name

Phone

Email

Father's Name

Phone

Email

Emergency Contact Name *

Home Phone

Cell Phone

Relationship to student *

Allergies or other medical conditions: *

Parents/Guardians:

Teacher
Teacher Assistant
VBS Leader
Children’s Special Events
Help with Children’s Choir
Share special talents with children: i.e. storytelling, painting, etc.