PVUMC Children's Registration Form

Birth-5th Grade Registration Form

Please fill out one form for each child
Child's Name

First Middle Last
Birth Date

Month Day Year
Gender *
Current Grade

Infants Toddlers and 2's 3 and 4 year old class Kindergarten 1st grade 2nd grade 3rd grade 4th grade 5th grade
Address

Home Address

Address Line 2

City State / Province

Zip Code Country
Parent/Guardian's Name

First Name Last Name
Parent/Guardian's Name

First Name Last Name
Parent E-mail
Preferred Number

Area Code Phone Number
Work Number

Area Code Phone Number
Allergies or concerns
Areas child is involved in

8:15 Children's Church 9:45 Sunday School 11:15 Children's Church Wednesday Nights Can Do Kids - Thursday nights
Should be Empty:

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Birth-5th Grade Registration Form