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Register Your Children

At Kingdom Kidz, we want to serve your children as best as we can.  To do this, we need some information.  That's why we ask you to please fill out this registration form.  It helps us get to know your children's likes & dislikes and their other needs. 

Fields marked with a * are required.

* 1st Child's Name:

* Birthday:

2nd Child's Name:

Birthday:

3rd Child's Name:

Birthday:

4th Child's Name:

Birthday:

* Address: 

* City:

St:

* Zip:

* Home Phone:

 

 
* Email:

 

* Father's Name:

* Mother's Name:

Occupation:

Occupation:

Work/Cell Phone:

Work/Cell Phone:

 

Child's Allergies:

Other Needs:

Any Fears or Special Characteristics?

(Doesn't like to get dirty, afraid of the dark, etc.)

 

My children have asked Jesus into their hearts:

1st Child

Yes     No

 

2nd Child

Yes     No

 

3rd Child

Yes     No

 

4th Child

Yes     No

 

My children have been to church before:

Yes     No

If Yes, where:

 

We ask all parents to volunteer with our children a minimum of once per month.  Would you be willing to help out?

Yes, count me in     No, not yet.

 

I would be interested in the following:

Marriage Seminars/Classes:     Yes

 

Parenting Seminars/Classes:     Yes

 

Financial Seminars/Classes:     Yes

 

Thanks for taking the time to help us serve your children better.  Please be assured that all information will be kept confidential.  Click on the "Submit Registration Form" Button below to complete your registration.