2025-26 SUNDAY REGISTRATION | Park Hills Church

Welcome to Park Hills Church Sunday Morning ministry to children!
Please provide the following information about your child.

CHILD'S Information

Name

*

Address

*

Birthdate

*

Gender

*

Please select one option.

M F

Grade

*

Please select one option.

No Grade Pre-Kindergarten Kindergarten 1st 2nd 3rd 4th 5th

Allergies/Medical Needs

CHILD Contact Information

Please enter the contact information we can use as the primary way to communicate with the parent/guardian of the child

Email

*

This address will receive a confirmation email

Mobile

*

Parent / Guardian Contact Information

Please fill in all the areas that apply.

PARENTS / GUARDIANS

Primary Contact Name

*

Primary Cell Phone

*

Secondary Contact Name

Secondary Cell Phone

In the case of an emergency and the parent/guardian cannot be reached, please notify

Emergency Contact Name

*

Emergency Contact Number

*

Other Information that you would like us to know about your child

Other Comments

Please note: Only people with pick-up tags, or noted on this form will be allowed to pick up your child(ren) from Park Hills Church children's ministry events.

Description

Welcome to Park Hills Church Sunday Morning ministry to children!
Please provide the following information about your child.

Please Fix the Following

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