Home
About
What We Believe
Plan Your Visit
Leadership
Connect
Compassion Ministries
Missions
Adults
Children
Youth
Events
Worship
Give
Welcome to Monument Presbyterian Children's Ministry
This registration for is for first time families.
Already registered?
No need to fill this form out again!
Parent Information
First Name
Last Name
Email
Phone Number
Address
Apartment, suite, etc.
City
State
Zip/Postal Code
How did you hear about us?
Family or Friend
Church Website
Social Media
Community Event
Other
Child's Information
Child's First Name
Child's Last Name
Birthdate
Month
January
February
March
April
May
June
July
August
September
October
November
December
Date
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
Year
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Gender
Male
Female
I'd rather not say
Grade
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Allergies
Which program(s) are you registering for?
Sunday Morning Kids (Birth–5th Grade)
3, 4, 5 Event (for 3rd-5th grade)
Youth Group (6th–12th Grade)
Vacation Bible School
Any special needs or accommodations we should know about?
Does this child have any medical conditions you would like to make us aware of?
No
Yes
If yes, please describe
Agreements & Authorization
Photo/Video Release
Photo/Video Release Permission
I grant permission
I do not grant permission
Authorized Pickup Contacts
Please list anyone other than yourself that is authorized to pick up your child(ren). They will need to provide the security code shown in your app.
Parent/Guardian Signature
By Signing this form below, I agree that the information provided is accurate and I authorize Monument Presbyterian Church to care for my child during children ministry programs.
I agree to sign this form electronically.
Agreements & Authorization
Photo/Video Release
Photo/Video Release Permission
I grant permission
I do not grant permission
Authorized Pickup Contacts
Please list anyone other than yourself that is authorized to pick up your child(ren). They will need to provide the security code shown in your app.
Parent/Guardian Signature
By Signing this form below, I agree that the information provided is accurate and I authorize Monument Presbyterian Church to care for my child during children ministry programs.
I agree to sign this form electronically.
<
Back
Next
>
Submit
