Children and Youth: SC Kidz | Sanctuary Church

Children & Youth Church Registration

Name (Required)

Email Address (Required)

Child's First Name (Required)

Child's Middle Name

Child's Last Name (Required)

Child's birthday (Required)

Grade (Required)

Gender (Required)

Mailing Address (Required)

Mother's Name (Required)

Mother's Phone Number (Required)

Father's Name (Required)

Father's Phone Number (Required)

Email address you would like us to use to contact you? (Required)

Authorized people to pick up the Child. (Must be 18 years or older) (Required)

Is there custodial information that we should be aware of? If yes, please list below. (Required)

Custodial Information

Do you have a church home?

If you do not have a church home, would you like to be contacted to learn more about our church?

Emergency Contact's Name (Required)

Relationship to the Child (Required)

Emergency Contact's Cell Phone Number

Does the child have allergies, chronic illness, or medical conditions? (Required)

If yes, please describe the allergies, chronic illness, or medical conditions. (Required)

Are there any special conditions that we need to be aware of? (Required)

If there are special consideration to be aware of, please describe. (Required)

Is your child taking any medications? (Required)

If yes, please list the medication and the reason for the medication. (Required)

Is there anything else that we should be aware of?

Sanctuary Church

3201 W. 15th Street, Plano, TX 75075

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