Form

Child Registration Form
Please fill out the following information. If you have any questions please contact:
Leslie Damann at 618-277-4659 or lesliedamann@mychristchurch.com.

When we receive your registration it will be entered in the system and you will be pre-registered for Sunday morning. Stop by the check in desk to print child and parent tags.
Family Information
Which service/program are you registering your child(ren) for

Collinsville / Maryville Sun 10am Fairview Heights Sat 5pm Fairview Heights Sun 8:30am Fairview Heights Sun 10:30am Fairview Heights Sun 6pm (AWANA, Jump IN)
Head of the household information:
Name*
First Name Last Name
E-mail*
Birth Date
Month Day Year
Home #
- Area Code Phone Number
Work #
- Area Code Phone Number
Cell #*
- Area Code Phone Number

Address*

Other Information
We use texting as our primary way of contacting parents / guardians while children are in our care.

(If you do not have a cell phone, the security number will be shown on the screens in the sanctuary)
What is the best cell phone number to reach you
- Area Code Phone Number
Would you like to join our mailing list to receive news and event information about Christ Church?

yes no
How did you learn about Christ Church
Are you a military family?

yes no
We believe in the power of prayer. How can we pray for you today?
Should be Empty:

Child Registration Form