Kid’s Worship Enrollment Form Name* First and Last Date of Birth* Please include month, day and year. Gardian’s Name(s)* Include First and Last Names Please. Address For mailing purposes only. Please include town and zip code. email For informational purposes. Include all emails you would like us to use. Phone Number (Primary) Please Include Area Code Phone Number (Secondary) Please Include Area Code Sibling’s Name(s) and Age(s) Child’s Interests 0 of 100 max characters Allergies 0 of 100 max characters Child’s Dislikes 0 of 100 max characters Other Information/Concerns 0 of 100 max characters Parental Contact* yes I acknowledge that if my child becomes inconsolable during the service, I will be contacted to help with the situation. Consent to be Photographed* yes no I give consent for my child to be photographed for use on this form.
