Primary Parent Contact Name *

First Name

Last Name

Secondary Adult Contact (Parent/Guardian/Grandparent)

First Name

Last Name

Primary Adult Phone Number *

(###)

###

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Please indicate which activities/ministries your child(ren) may participate in this program year: *

Nursery Care (Ages 4 and under)

Sunday Sunday (PreK - Grade 5)

Sunday School (Grades 6-8)

Sunday School (Grades 9-12)

Confirmation (Ages 15 and up)

Youth Group (Middle or High School)

Outreach Activities

Trips (Mission/Pilgrimage/Retreat)

Acolyte or Lay Reader

Children's Worship

Volunteer Interest *

Please check all that apply regarding your interest in volunteering with children and youth this year

I am not interested in volunteering with children and youth this year.

I am interested in volunteering on a regular (weekly or monthly) basis with children.

I am interested in volunteering on a regular (weekly or monthly) basis with youth.

I am interested in volunteering where I am needed at events.

I am interested in chaperoning trips (mission, pilgrimage, retreat).

I am interested in volunteering in the nursery.