WCC Children’s Ministry Online Registration
Register your child for children's ministry at Waushara Community Church
Student Information
Child’s First Name:
Your answer
Child’s Last Name:
Your answer
Grade Entering: (Note: Children are placed in classes based on their age as of September 1st .)
Gender:
Your answer
Birthdate:
MM
/
DD
/
YYYY
My child has received Jesus as Savior:
Medical Concerns?:
Explain medical concerns:
Your answer
Learning Issues?:
Explain learning issues:
Your answer
Food Allergies?:
Explain food allergies:
Your answer
Family Information
Parents/Guardian First Name:
Your answer
Parents/Guardian Last Name:
Your answer
Street Address:
Your answer
PO Box:
Your answer
City:
Your answer
State:
Your answer
Zip:
Your answer
Home Phone:
Your answer
Cell Phone:
Your answer
Email:
Your answer
Relationship to Student:
Your answer
I give permission for my child’s picture to be used in promoting WCC’s Children’s Ministry:
To ensure child safety, I agree to accompany my child (Preschool 2 through Grade 3) both to and from my child’s classroom:
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms