Child's Name
*
First Name
Last Name
Grade
*
Parent Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
E-mail
*
When did your child accept Christ?
Has your child been baptized?
*
Yes
No
At least one parent must attend class with child. Who will attend?
*
Please Select
Mother
Father
Both
Guardian
Do you need childcare for other children?
*
Yes
No
If yes, please list names and ages
Submit
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