Family Registration Form - Eastern Hills Community Church

Children's Ministry Family Registration Form

If you have more than three children, please download and print this form, and email it to lgesink@ehills.org

Parent(s) / Guardian Information

Parent First Name (required)
Parent Last Name (required)
Address (required)
City (required)
State (required)
Zip (required)
Spouse
Occupation
Home Phone (required)
Cell Phone
Work Phone
Email Address

First Child Information

First Child Name (required)
First Child Sex

Male Female
First Child Birthday (required)
First Child Grade Level (required)
First Child School (required)
First Child Allergies/SpecialNeeds

Second Child Information

Second Child Name
Second Child Sex

Male Female
Second Child Birthday
Second Child Grade Level
Second Child School
Second Child Allergies/SpecialNeeds

Third Child Information

Third Child Name
Third Child Sex

Male Female
Third Child Birthday
Third Child Grade Level
Third Child School
Third Child Allergies/SpecialNeeds