Second Sundays for Kids Registration

Child's Information

First :
Last :
Age :
Grade Last Completed :

Parent Information

Father's Name
First :
Last :

Mother's Name
First :
Last :

Address Information

Street :
City : State : Zip

Contact Information

Home Phone :
Cell Phone :
Email :
Emergency Contact Name :
Emergency Contact Number :

Additional Information


Please provide any additional information (i.e. Food allergies) you wish to inform us about.

Second Sundays Attending

Please inform us of which sessions your child will be attending.
June 14thJuly 12thAugust 9th