Child New Member Form

Thank you for taking the time to update your member contact information.

Please complete one form for each new child member.

Child First Name *

Child Middle Name

Child Last Name*

Gender*

Birth date*

Parent/Guardian Full Name*

Home Address*

City*

State*

Zip Code*

Parent/Guardian Cell Phone*

Parent/Guardian Home Phone

Parent/Guardian Work Phone

Parent/Guardian Email*

How Did You Join

This information will only be used for the purposes of keeping you informed and updated on the life of our church.