Wiggle Church Interest Form
Wiggle Church is worship designed especially for young children and their grown-ups! Wiggle Church gives you time together to explore faith, make new friends, and play with your young ones!
Child Name
*
First Name
Last Name
Child Birthday
Please select a month
January
February
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December
Month
Please select a day
1
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Day
Please select a year
2024
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Year
Baptized?
*
Please Select
Yes
No
In the process
Child's School
Medical or health concerns (Food allergies, etc.)
Parent 1
First Name
Last Name
Phone Number
Please enter a valid phone number.
Parent 2
First Name
Last Name
Phone Number
Please enter a valid phone number.
Family Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Where is your "home church"?
*
Submit
Should be Empty: