Children's Ministry Pre-Registration - Broadway Christian Church

Mom's Name

First Last

Dad's Name

First Last

Parent Email*

Primary Phone*

Child's Name*

First Last

Male
Female

Child's Date of Birth

Child's Current Grade

Allergies or Special Needs?*

Yes
No

If yes, please describe...

Add Additional Children

Child's Name

First Last

Male
Female

Child's Date of Birth

Child's Current Grade

Allergies or Special Needs?

Yes
No

If yes, please describe...

Add Additional Children

Child's Name

First Last

Male
Female

Child's Date of Birth

Child's Current Grade

Allergies or Special Needs?

Yes
No

If yes, please describe...

Add Additional Children

Child's Name

First Last

Male
Female

Child's Date of Birth

Child's Current Grade

Allergies or Special Needs?

Yes
No

If yes, please describe...

Add Additional Children

Child's Name

First Last

Male
Female

Child's Date of Birth

Child's Current Grade

Allergies or Special Needs?

Yes
No

If yes, please describe...

Do you agree to allow photos/videos of your child to be used in church presentation or church promotional materials?*

Yes
No

Kids Ministry Pre-Registration