Welcome to Mercy Road Kids
Please use this form to register your child(ren) for our Mercy Road Kids Ministry
Email address *
Child(ren)'s name, date of birth and grade (if in school): *
Your answer
Parent name(s): *
Your answer
Parent #1 email: *
Your answer
Parent #2 email:
Your answer
Home Address: *
Your answer
Parent #1 Cell number and provider (for text reminders): *
Your answer
Parent #2 Cell number and provider (for text reminders):
Your answer
Allergy Information:
Your answer
Helpful information about your child(ren) that you would like us to know:
Your answer
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