RESURGENT KIDS

Elementary (Kindergarten – 5th grade), Pre-K, and nursery classes are available.

RESURGENT KIDS

Our children’s ministry meets every Sunday at 10:00 AM. Elementary (Kindergarten – 5th grade), Pre-K, and nursery classes are available.

STUDENT REGISTRATION

Please complete the form below for each child in your household.

(For children from 0 – 5th grade. 6th – 12th has a separate form on the youth page.)

Receiving this information will allow us to better serve you and your family!

Please complete the form below for each student in your household.

(For children from 0 – 5th grade. 6th – 12th has a separate form on the youth page.)

Receiving this information will allow us to better serve you and your family!

Student First Name *

Student Last Name *

Student Age *

Student Birthday *

Student's School *

Student Grade *

Does he/she have any food allergies or medical conditions we should be aware of?

Any other important information you would like us to know?

Are the student's parents married? *

Home Address *

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Parent First Name *

Parent Last Name *

Parent Phone *

Parent Email *

Secondary Parent First Name

If inapplicable, leave spaces for secondary contact blank.

Parent Last Name

Parent Phone

Parent Email

Website