Fellowship Kids Registration 2024/25

1
Parent/Guardian 1* This field is required.
First Name
Last Name
Email Address
Phone Number (for Emergency Contact)
2
Parent/Guardian 2
First Name
Last Name
Email Address
Phone Number (for Emergency Contact)
3
Address* This field is required.
Street Address
Street Address Line 2
City
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
4
Are you a Fellowship:* This field is required.
Member
Regular Attendee
Visitor
5
What is your home church?
6
Do you wish to provide an alternative emergency contact, in place of the parent/guardian?
YESNO
7
Name of Emergency Contact* This field is required.
First Name
Last Name
Phone number
Relationship
8
Child 1 Information* This field is required.
Child's First Name
Child's Last Name
Please Select
Please Select
Male
Female
Child's Gender
School
Please Select
Please Select
Age 3 (by Oct. 1)
Age 4 (by Oct. 1)
Pre-K/Kindergarten (age 5 by Dec. 1)
1st
2nd
3rd
4th
5th
Grade (Fall)
9
Birth Date* This field is required.Please use calendar icon to make selection.
Date
Month
Day
Year
10
Allergies/Special Instructions* This field is required.
11
Kids Ministry Program Enrollment

Below is a description of each program. Please select all programs you wish to enroll your child in on the next page.

Kids Worship - Age 3-K, during Sunday services, Year-round

Sunday School - Age 3 (by Oct. 1) -5th Grade, Sundays 9:50-10:40a, September-May

JR. JAM - Age 4 (by Oct. 1) -K, Wednesday 6:30-8:00p, September-March

JAM - 1st-2nd Grade, Wednesday 6:30-8:00p, September-March

GEMS Girls - 3rd-5th Grade, Wednesday 6:30-8:00p, September-March

BOOM! Boys - 3rd-5th Grade, Wednesday 6:30-8:00p, September - March
12
Program Enrollment* This field is required.Please check all programs that you wish to enroll your child in.
Kids Worship (Age 3-K)
Sunday School (Age 3-5th Grade)
JR. JAM (Age 4-K)
JAM (1st-2nd Grade)
GEMS (Girls - 3rd-5th Grade)
BOOM! (Boys - 3rd-5th Grade)
13
Would you like to add a second child?* This field is required.
YESNO
14
Child 2 Information* This field is required.
Child's First Name
Child's Last Name
Please Select
Please Select
Male
Female
Child's Gender
School
Please Select
Please Select
Age 3 (by Oct. 1)
Age 4 (by Oct. 1)
Pre-K/Kindergarten (age 5 by Dec. 1)
1st
2nd
3rd
4th
5th
Grade (Fall)
15
Birth Date* This field is required.Please use calendar icon to make selection.
Date
Month
Day
Year
16
Allergies/Special Instructions* This field is required.
17
Kids Ministry Program Enrollment

Below is a description of each program. Please select all programs you wish to enroll your child in on the next page.

Kids Worship - Age 3-K, during Sunday services, Year-round

Sunday School - Age 3 (by Oct. 1) -5th Grade, Sundays 9:50-10:40a, September-May

JR. JAM - Age 4 (by Oct. 1) -K, Wednesday 6:30-8:00p, September-March

JAM - 1st-2nd Grade, Wednesday 6:30-8:00p, September-March

GEMS Girls - 3rd-5th Grade, Wednesday 6:30-8:00p, September-March

BOOM! Boys - 3rd-5th Grade, Wednesday 6:30-8:00p, September - March
18
Program EnrollmentPlease select all programs you wish to enroll your child in.
Kids Worship (Age 3-K)
Sunday School (Age 3-5th Grade)
JR. JAM (Age 4-K)
JAM (1st-2nd Grade)
GEMS (Girls - 3rd-5th Grade)
BOOM! (Boys - 3rd-5th Grade)
19
Would you like to add a third child?* This field is required.
YESNO
20
Child 3 Information* This field is required.
Child's First Name
Child's Last Name
Please Select
Please Select
Male
Female
Child's Gender
School
Please Select
Please Select
Age 3 (by Oct. 1)
Age 4 (by Oct. 1)
Pre-K/Kindergarten (age 5 by Dec. 1)
1st
2nd
3rd
4th
5th
Grade (Fall)
21
Birth Date* This field is required.Please use calendar icon to make selection.
Date
Month
Day
Year
22
Allergies/Special Instructions* This field is required.
23
Kids Ministry Program Enrollment

Below is a description of each program. Please select all programs you wish to enroll your child in on the next page.

Kids Worship - Age 3-K, during Sunday services, Year-round

Sunday School - Age 3 (by Oct. 1) -5th Grade, Sundays 9:50-10:40a, September-May

JR. JAM - Age 4 (by Oct. 1) -K, Wednesday 6:30-8:00p, September-March

JAM - 1st-2nd Grade, Wednesday 6:30-8:00p, September-March

GEMS Girls - 3rd-5th Grade, Wednesday 6:30-8:00p, September-March

BOOM! Boys - 3rd-5th Grade, Wednesday 6:30-8:00p, September - March
24
Program EnrollmentPlease select all programs you wish to enroll your child in.
Kids Worship (Age 3-K)
Sunday School (Age 3-5th Grade)
JR. JAM (Age 4-K)
JAM (1st-2nd Grade)
GEMS (Girls - 3rd-5th Grade)
BOOM! (Boys - 3rd-5th Grade)
25
Would you like to add a fourth child?* This field is required.
YESNO
26
Child 4 Information* This field is required.
Child's First Name
Child's Last Name
Please Select
Please Select
Male
Female
Child's Gender
School
Please Select
Please Select
Age 3 (by Oct. 1)
Age 4 (by Oct. 1)
Pre-K/Kindergarten (age 5 by Dec. 1)
1st
2nd
3rd
4th
5th
Grade (Fall)
27
Birth Date* This field is required.Please use calendar icon to make selection.
Date
Month
Day
Year
28
Allergies/Special Instructions* This field is required.
29
Kids Ministry Program Enrollment

Below is a description of each program. Please select all programs you wish to enroll your child in on the next page.

Kids Worship - Age 3-K, during Sunday services, Year-round

Sunday School - Age 3 (by Oct. 1) -5th Grade, Sundays 9:50-10:40a, September-May

JR. JAM - Age 4 (by Oct. 1) -K, Wednesday 6:30-8:00p, September-March

JAM - 1st-2nd Grade, Wednesday 6:30-8:00p, September-March

GEMS Girls - 3rd-5th Grade, Wednesday 6:30-8:00p, September-March

BOOM! Boys - 3rd-5th Grade, Wednesday 6:30-8:00p, September - March
30
Program EnrollmentPlease select all programs you wish to enroll your child in.
Kids Worship (Age 3-K)
Sunday School (Age 3-5th Grade)
JR. JAM (Age 4-K)
JAM (1st-2nd Grade)
GEMS (Girls - 3rd-5th Grade)
BOOM! (Boys - 3rd-5th Grade)
31
Medical Information
Doctor's Name
Doctor's Phone Number
Preferred Hospital
32
Additional Medical InformationFor GEMS and BOOM!
Insurance Company
Policy Number
Policy Holder
Group Number
33
Is my child(ren) interested in having a spoken line in the 2024 Christmas Program?I understand that my child(ren) needs to be enrolled and attend Sunday School, and that they will be present at all required practices and program. 1. The program will be at the 11:00 service on Sunday, December 8. 2. Those signing up for 4th and 5th grade parts will be in the drama. 3. Drama practices will be Saturday, Nov. 16 and Saturday, Nov. 23. 4. Final practice for all program participants will be on Saturday, December 7.
YESNO
34
Christmas Program Registration for Spoken Lines
Child 1 Name
Please Select
Please Select
Age 3 (by Oct. 1)
Age 4 (by Oct. 1)
Pre-K/Kindergarten (age 5 by Dec. 1)
1st
2nd
3rd
4th
5th
Child 1 Grade
Child 2 Name
Please Select
Please Select
Age 3 (by Oct. 1)
Age 4 (by Oct. 1)
Pre-K/Kindergarten (age 5 by Dec. 1)
1st
2nd
3rd
4th
5th
Child 2 Grade
Child 3 Name
Please Select
Please Select
Age 3 (by Oct. 1)
Age 4 (by Oct. 1)
Pre-K/Kindergarten (age 5 by Dec. 1)
1st
2nd
3rd
4th
5th
Child 3 Grade
Child 4 Name
Please Select
Please Select
Age 3 (by Oct. 1)
Age 4 (by Oct. 1)
Pre-K/Kindergarten (age 5 by Dec. 1)
1st
2nd
3rd
4th
5th
Child 4 Grade
35
Terms and Conditions* This field is required.
36
Electronic Signature* This field is required.
First Name
Last Name
37
Date Signed* This field is required.
Date
Month
Day
Year
38
Please verify that you are human* This field is required.
Should be Empty: