Kids Church Registration Form
2026-2027
Child/Youth's Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Projected year of high school graduation:
Parents/Guardians
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Please sign me up for occasional Kids Church-related texts, including changes in schedule.
YES
Email
*
example@example.com
Child/Youth Allergies
Other Information
Interested in volunteering in Kids Church?
Yes
No
Please enroll me in text alerts for Kids Church important notifications, using the above cell phone number.
Yes
No
Knowing the curriculum is planned out well in advance, are there any Bible verses or teachings that you are particularly interested in your child/youth learning about this year?
Submit
Should be Empty: