Children and Youth Activity Registration Form

Please complete and submit one form for each participant.
Child's name:
 Gender:
 Female
Male
Child's age as of 09/01/2007
 Grade completed
Address
State
 Zip Code
City
Email Address:
 Date of birth:
Home Phone Number:
 Cellphone:
Parent/Guardian Name(s):
School Child Attends:
 Church Affiliation:

Activities for which you are registering:

Additional Comments:

Please send me weekly A.R.K. Take Home Cards (check box)
For more information on events, such
as age requirements, costs, time, and
what to bring, please check out our
children and youth pages!