REGISTRATION FORM
Newman's Children's Ministries Programs

Family Last Name:

Home Address:

Email Address:

Telephone #'s:

Information of each child being registered:
Child's Name                DOB                Grade as of 9/1        Medical / Other Concerns







With whom do we speak with any questions or concerns we may have?



Newman's Children's Ministries programs are a cooperative effort which takes many volunteers helping in a variety of ways.  How can you help? (check any or all that apply)

                       Helper with little ones on occasion

                       Helper with older children on occasion

                       Assist with fellowship groups on occasion

                       Help with related activities like bazaar or potlucks

                       Other (specify)


I certify that the above information is true to the best of my knowledge.


Name of adult registering child(ren):