Family Information
This information will be used for contact purposes only.
Parent 1 Name
*
First Name
Last Name
Parent 2 Name
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Home Church (if applicable)
Best method to contact me by :
I would like to register my child/ren for
*
Sunday School
Mid Week programs
Both
Number of children registering:
*
Please Select
1
2
3
4
5
6
7
8
9
10 or more
Please write your child(ren)'s name, birthday, and grade. Name - Mon DD, YYYY - Grade ___
*
Ex: Susie - Jan 1, 2009 - Grade 10
Please list any issues we should be aware of such as food allergies, medical concerns, etc.
I agree to have my child's photo used on...
Our church website (www.kemc.net)
Church bulletin
Church Program Brochure
Slide Shows within your child's program
Submit
Should be Empty: