U18 Registration Please fill out the form below to register your child for one of our U18 Ministries. Please enable JavaScript in your browser to complete this form.Program *Kid's Mid-WeekJunior YouthSenior YouthChild's Name *FirstLastM/FMaleFemaleChild's Date of Birth *Month/Day/YearAddress (Number/Street/Town/Postal Code)Parent/Guardian Name *FirstLastaddress is the same as childAddress if different from childHome Phone *if you don't have a home phone, complete with your cell numberCell PhoneHome Church (if applicable)Email *Name of Emergency Contact (if necessary) *FirstLastEmergency Contact Phone Number(s) *Emergency Contact's Relation to Child *My child has allergies, health concerns, or is special needs *YesNoPlease explain any other health concerns or relevant informationPictures of my child may be taken during any program and may be used for in-house purposes: slideshows, games, media presentations, etc *YesNoSignature of Parent/Guardian *By typing your name in this box you are applying your electronic signature, making it an official document for our record.Today's Date *PhoneSubmit Share this:Click to share on Facebook (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on Pinterest (Opens in new window)