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Children’s Ministry Enrollment Form
Stones River Church of Christ
Appendix E
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* Indicates required question
Email
*
Your email
Parent Information
Mother's Name
Your answer
Father's Name
Your answer
Home Phone Number
Your answer
Other Parental Email Address
Your answer
Cell Phone Number(s)
Your answer
Minor(s) live with
Your answer
Alternate Emergency Contact
Please provide their: Name / Relationship / Best Way to Contact
Your answer
Other Family Information
Your answer
Child Information
First Child
Minor's Full Name, Date of Birth, Food Allergies or Medical Needs, and any additional information
Your answer
Second Child
Minor's Full Name, Date of Birth, Food Allergies or Medical Needs, and any additional information
Your answer
Third Child
Minor's Full Name, Date of Birth, Food Allergies or Medical Needs, and any additional information
Your answer
Fourth Child
Minor's Full Name, Date of Birth, Food Allergies or Medical Needs, and any additional information
Your answer
Additional Children
Minor's Full Name, Date of Birth, Food Allergies or Medical Needs, and any additional information
Your answer
A copy of your responses will be emailed to the address you provided.
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