Children's Ministry Family Registration

Please fill out this form and click submit.

Parent or Guardian #1

First name

*

Last name

*

Gender

*

Please select all that apply.

Male Female

Relationship to Child

*

Please select one option.

Parent Guardian Other family member

Email address: name@example.com

*

This address will receive a confirmation email

We are:

*

Please select all that apply.

New to Waypoint Kids. This is an update to our family or contact information.

Please check this box if you are adding a new family member or changing your current contact information.

Home

Street address

*

City

*

State

*

Zip Code

*

Phone

Mobile

*

Other

Parent/Guardian #2

First name

Last name

Gender

*

Please select all that apply.

Male Female

Relationship to child

Please select one option.

Parent Guardian

Email address: name@example.com

Address (if different)

Mobile phone

Other phone

Child #1

First name

*

Last name

*

Date of Birth

*

Gender

*

Please select all that apply.

Male Female

Grade

*

Please select one option.

Infant Toddler 2-Year-Old 3-Year-Old 4-Year-Old TK Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade

Medical Notes (allergies, etc.)

Child #2

First name

*

Last name

*

Date of Birth

*

Gender

*

Please select all that apply.

Male Female Option

Grade

*

Please select one option.

Infant Toddler 2-Year-Old 3-Year_old 4-Year-Old TK Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade

Medical Notes (allergies, etc.)

Child #3

First name

Last name

Date of Birth

Gender

Please select all that apply.

Male Female

Grade

Please select one option.

Infant Toddler 2-Year-Old 3-Year-Old 4-Year-Old TK Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade

Medical Notes (allergies, etc.)

Child #4

First name

Last name

Date of Birth

Gender

Please select all that apply.

Male Female

Grade

Please select one option.

Infant Toddler 2-Year-Old 3-Year-Old 4-Year-Old TK Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade

Medical Notes (allergies, etc.)

Description

Please fill out this form and click submit.

Please Fix the Following

Close