Childcare Registration

We are offering childcare for infants through 4th grade for our Prayer & Game Night. Please fill out a separate form for each child. Thank you!

Parent Info

First Name

Last Name

Phone Number

This number will be called/texted during the event if the need arises.

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Email

Child Info

First Name

Last Name

Age

Please list any food allergies, medical concerns, or other information we should be aware of: