Emmanuel Children's Ministry Registration
The Children's Ministry (eNursery, eKids, and e56) uses a computer-based check-in system. Please fill out the information below if you haven't already submitted the paper form to Cheryl, Krista, or Patti. If you have multiple children, you will need to fill the form out separately for each child.
Child's Name *
Your answer
Date of Birth *
Your answer
Address *
Your answer
City, State, Zip *
Your answer
Please choose the appropriate program that your child will attend: *
Contact Information:
Father's Name
Your answer
Father's Cell Phone
Your answer
Home Phone
Your answer
Email
Your answer
Address (If different from child's)
Your answer
Mother's Name
Your answer
Mother's Cell Phone
Your answer
Home Phone
Your answer
Email
Your answer
Address (If different from child's)
Your answer
Other Guardian
Your answer
Guardian Cell Phone
Your answer
Guardian Home Phone
Your answer
Email
Your answer
Guardian's Address (If different from child's)
Your answer
Allergies & Medical / Other Concerns
Allergies: (enter NONE if none) *
Your answer
Medical / Other Concerns: (enter NONE if none) *
Your answer
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