KidMin! Online Registration Form
Registration for KidMin! at Glory Baptist Church - school year 2020-21.

Program starts September 16th @ 6:30 p.m. 2020!

Family meal provided from 6:00-6:30 p.m. in our lower level.

Please register each child separately!
Email address *
Student Name *
Street Address *
City *
Zip *
Gender *
Required
DOB (MM/DD/YY) *
Grade for 2020-21 school year *
Best Phone Number to Reach a Parent/Guardian *
Mother's (or guardian's) Name
Mother's Cell (or Home Phone)
Mother's Email Address
Father's (or guardian's) Name
Father's Cell (or Home Phone)
Father's Email Address
Who does child live with primarily? *
If other, please list who
If Mom's/Dad's address or home phone is different, type it here.
Please list any food allergies and/or medical conditions we need to be aware of.
Does your family attend church other than Glory Baptist Church? If so, where?
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