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KINDERKERK/CHILDREN'S MINISTRY REGISTRATION
Event Address:
Cnr Bauhinia & Koraalboom St, Louis Trichardt, Limpopo, South Africa
Contact us at:
+27 15 516 4282 or admin@emmanuellife.org
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* Indicates required question
Untitled Title
Untitled Title
Parent/Guardians Names (First and Last)
*
Your answer
Relation to child
*
Mother
Father
Legal Guardian
Other:
Email
*
Your answer
Phone
*
Your answer
Are you a member or a guest at Emmanuel Church Louis Trichardt?
*
Member
Guest
Required
Child 1. Name (First & Last)
*
Your answer
Child 1. Date of Birth
*
MM
/
DD
/
YYYY
Child 1. Gender
*
MALE
FEMALE
Child 1. Grade
*
Your answer
Allergies if any (if no type N/A)
*
Your answer
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