Register Your Child

*Preschool (3-5), Kindergarten/1st grade, & 4th/5th grade age ranges are full!
Thank you for registering your children.
2nd/3rd grades are still eligible for this year's VBS.

Masks for students and adults will be optional.

By registering your child(ren), you acknowledge that there may be children and adults not wearing face masks.

We found some errors when you submitted your information. Please see below and fill in the information needed.

Parent Personal Information

Parent First Name:

Parent Last Name:

Address 1:

Address 2:

City:

Country:

State:

Zip:

Email:

Re-Enter Email:

Home Phone Number: (xxx-xxx-xxxx)

Cell Phone Number: (xxx-xxx-xxxx)

Other Phone Number: (xxx-xxx-xxxx)

Emergency Contact

Emergency Contact First Name:

Emergency Contact Last Name:

Emergency Phone 1: (xxx-xxx-xxxx)

Emergency Phone 2: (xxx-xxx-xxxx)

Alternate Pickup First Name:

Alternate Pickup Last Name:

Alternate Pickup Phone: (xxx-xxx-xxxx)

Other Information

Home Church (If Applicable):