Children's Registration

WCB Children's Ministry
2017 - 2018 Registration Form

This form will be used for the entire Children's Ministry Program. Please select which areas you intend to register your child(ren) in for the year.

**Note** Do not use the RETURN key, it will send the form before it is finished. Use the TAB key or your mouse instead to move from field to field. : )
Parent /Guardian Information
Last Name: * 
First Name(s): * 
Address: * 
City/State: * 
Main Phone #: *  
2nd Contact #: 
Email: *  
Home Church:
Child 1:
Last Name: * 
First Name: * 
Attending at WCB: *


 
Date of Birth (mm/dd/yy): * 
Age: 
Grade (2017-18): * 
Gender: *
 
Does this child have any medical conditions (allergies, medications, etc.) that we should be aware of?
: *
 
If yes:
Child 2:
Last Name:
First Name:
Attending at WCB:


Date of Birth (mm/dd/yy):
Age:
Grade (2017-18):
Gender:
Does this child have any medical conditions (allergies, medications, etc.) that we should be aware of?
:
If yes:
Child 3:
Last Name:
First Name:
Attending at WCB:


Date of Birth (mm/dd/yy):
Age:
Grade (2017-18):
Gender:
Does this child have any medical conditions (allergies, medications, etc.) that we should be aware of?
:
If yes:
Child 4:
Last Name:
First Name:
Attending at WCB:


Date of Birth (mm/dd/yy):
Age:
Grade (2017-18):
Gender:
Does this child have any medical conditions (allergies, medications, etc.) that we should be aware of?
:
If yes:
Emergency Contact Information Needed for AWANA 6:00 - 8:00pm:
Name:
Phone #: 
Name:
Phone #: 
Check In & Check Out
You as parent/guardian are responsible for checking your child in each day and will be required to sign your child out. You must communicate with the current teacher/leader if someone other than yourself will be picking up your child.
: * 


Thank you for completing this form.
We pray that your children will learn to know God and His son, Jesus through this fun filled program!!

Invite your friends!
God Bless!
South Dakota Website Design and Development