Winter/Spring 2012 Children's Programs Pre-Registration

Winter/Spring 2012 Children's Program Registration

Please fill out your contact information below.

Please fill out one registration form per child. There is NO cost involved. Registration is required.

Wednesday night programming will be held January 11th - April 25th, 2012 from 7:00 - 8:30 pm. All children aged 4 - 11 are invited.

Youth Group meets on Fridays beginning January 13th, 2012 from 7:00 - 9:00 pm. All youth aged 12 - 18 are invited.

Children's Church during our weekend wervices is held on Saturdays at 6:00 pm and Sundays at 10:30 am. All children under 11 yrs old are invited.

Parent/Guardian's Name*

First Name

Last Name

Address*

City

State

Zip Code

Best Phone Number to Reach Me*

Home Cell Work

Child's Name*

Child's Age* 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Program (please check as many as apply) Toddler Area (1 - 3 yrs) WED from 7:00 - 8:30 pm
Kidz Klub (4 - 8 yrs) WED from 7:00 - 8:30 pm
Jr Explorers Club (9 - 11 yrs) WED from 7:00 - 8:30 pm
Youth Group (12 - 18 yrs) FRI from 7:00 - 9:00 pm
Nursery (<1 - 3 yrs) SAT from 6:00 - 7:30 pm
Children's Church (4 - 11 yrs) SAT from 6:00 - 7:30 pm
Nursery (<1 - 3 yrs) SUN from 10:30 - 12 noon
Children's Church (4 - 11 yrs) SUN from 10:30 - 12 noon

Child's Allergies or Special Instructions

Comments

	Winter/Spring 2012 Children's Program Registration Please fill out your contact information below. Please fill out one registration form per child. There is NO cost involved. Registration is required. Wednesday night programming will be held January 11th - April 25th, 2012 from 7:00 - 8:30 pm. All children aged 4 - 11 are invited. Youth Group meets on Fridays beginning January 13th, 2012 from 7:00 - 9:00 pm. All youth aged 12 - 18 are invited. Children's Church during our weekend wervices is held on Saturdays at 6:00 pm and Sundays at 10:30 am. All children under 11 yrs old are invited.
	Parent/Guardian's Name* First Name Last Name
	Address* City State Zip Code
	Best Phone Number to Reach Me*
	Home Cell Work
	Child's Name*
	Child's Age* 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
	Program (please check as many as apply) Toddler Area (1 - 3 yrs) WED from 7:00 - 8:30 pm Kidz Klub (4 - 8 yrs) WED from 7:00 - 8:30 pm Jr Explorers Club (9 - 11 yrs) WED from 7:00 - 8:30 pm Youth Group (12 - 18 yrs) FRI from 7:00 - 9:00 pm Nursery (<1 - 3 yrs) SAT from 6:00 - 7:30 pm Children's Church (4 - 11 yrs) SAT from 6:00 - 7:30 pm Nursery (<1 - 3 yrs) SUN from 10:30 - 12 noon Children's Church (4 - 11 yrs) SUN from 10:30 - 12 noon
	Child's Allergies or Special Instructions
	Comments

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Winter/Spring 2012 Children's Program Registration

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