Creative Worship Center

Children Church Signup Form for Ages Potty Trained- 11 Years of Age

Child First Name

Child Last Name

Parent First Name

Parent Last Name

Parent Phone Number

Child's Birthdate

Allergies

Gender

Phone Number

Email

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Is Child Baptized?

Yes

No

Wants to Get Baptized

Child Given Life to Christ

Yes

No

Wants to Give Life to Christ

What does child/parent want child to learn in children church?