2019 Children & Youth Ministry Reg. Form
Westover Hills United Methodist Church
Email address *
Child's Last Name *
Your answer
Child's First Name *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Age *
Your answer
Child's Current Grade in School *
Your answer
What school does child attend? *
Your answer
Mother's Name *
Your answer
Mother's Cell Phone Number *
Your answer
Father's Name *
Your answer
Father's Cell Phone Number *
Your answer
Father's Email *
Your answer
Home Address *
Your answer
Home Phone (if applicable)
Your answer
Person's Authorized to Pick up Child (Siblings MUST Be at least 14 years of age) *
Your answer
Does your child have any known allergies? *
If answered YES to any known allergies. Please explain. *
Your answer
Siblings (name and age) *
Your answer
Please name a few activities, sports, games and / or topics your child is interested in so that we may get to know your child better. *
Your answer
Additional comments to help us serve your family better:
Your answer
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