Registration Form for Under 18 Years

1
Church Location
Morgantown
Monongahela
2
Date Submitted
Date
Year
Month
Day
3
1st Child's Name
First Name
Last Name
4
1st Child's Nickname(Skip if not applicable)
5
1st Child's Birthday
Date
Month
Day
Year
6
1st Child's Age(If under 1 year, please enter 0)
7
1st Child's Grade
Not in School
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
8
Would you like us to change 1st child's diaper?
YESNO
9
Father's Name(Skip if not applicable)
First Name
Last Name
10
Mother's Name(Skip if not applicable)
First Name
Last Name
11
Guardian's Name(Skip if not applicable)
First Name
Last Name
12
Guardian's Relation to 1st Child
13
Address
Street Address
Street Address Line 2
City
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
14
Father's Cellphone #
15
Mother's Cellphone #
16
Guardian's Cellphone #
17
Which phone is the best contact?
Father's Cell
Mother's Cell
Guardian's Cell
18
Email Address
example@example.com
19
Allergies or things you want 1st child to avoid
20
Other Comments/Instructions for 1st Child
Huge
Large
Normal
Small
Ok
Ok
21
Would you like to register another child?
YESNO
22
2nd Child's Name
First Name
Last Name
23
2nd Child's Nickname(Skip if not applicable)
24
2nd Child's Relation to 1st Child
25
2nd Child's Birthday
Date
Year
Month
Day
26
2nd Child's Age(If under 1 year, please enter 0)
27
2nd Child's Grade
Not in School
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
28
Would you like us to change 2nd child's diaper?
YESNO
29
Allergies or things you want 2nd child to avoid
30
Other Comments/Instructions for 2nd Child
Huge
Large
Normal
Small
Ok
Ok
31
Would you like to register another child?
YESNO
32
3rd Child's Name
First Name
Last Name
33
3rd Child's Nickname(Skip if not applicable)
34
3rd Child's Relation to 1st Child
35
3rd Child's Birthday
Date
Year
Month
Day
36
3rd Child's Age(If under 1 year, please enter 0)
37
3rd Child's Grade
Not in School
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
38
Would you like us to change 3rd child's diaper?
YESNO
39
Allergies or things you want 3rd child to avoid
40
Other Comments/Instructions for 3rd Child
Huge
Large
Normal
Small
Ok
Ok
41
Would you like to register another child?
YESNO
42
4th Child's Name
First Name
Last Name
43
4th Child's Nickname(Skip if not applicable)
44
4th Child's Relation to 1st Child
45
4th Child's Birthday
Date
Year
Month
Day
46
4th Child's Age(If under 1 year, please enter 0)
47
4th Child's Grade
Not in School
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
48
Would you like us to change 4th child's diaper?
YESNO
49
Allergies or things you want 4th child to avoid
50
Other Comments/Instructions for 4th Child
Huge
Large
Normal
Small
Ok
Ok
51
Would you like to register another child?
YESNO
52
5th Child's Name
First Name
Last Name
53
5th Child's Nickname(Skip if not applicable)
54
5th Child's Relation to 1st Child
55
5th Child's Birthday
Date
Year
Month
Day
56
5th Child's Age(If under 1 year, please enter 0)
57
5th Child's Grade
Not in School
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
58
Would you like us to change 5th child's diaper?
YESNO
59
Allergies or things you want 5th child to avoid
60
Other Comments/Instructions for 5th Child
Huge
Large
Normal
Small
Ok
Ok
61
Would you like to register another child?
YESNO
62
6th Child's Name
First Name
Last Name
63
6th Child's Nickname(Skip if not applicable)
64
6th Child's Relation to 1st Child
65
6th Child's Birthday
Date
Year
Month
Day
66
6th Child's Age(If under 1 year, please enter 0)
67
6th Child's Grade
Not in School
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
68
Would you like us to change 6th child's diaper?
YESNO
69
Allergies or things you want 6th child to avoid
70
Other Comments/Instructions for 6th Child
Huge
Large
Normal
Small
Ok
Ok
71
Would you like to register another child?
YESNO
72
7th Child's Name
First Name
Last Name
73
7th Child's Nickname(Skip if not applicable)
74
7th Child's Relation to 1st Child
75
7th Child's Birthday
Date
Year
Month
Day
76
7th Child's Age(If under 1 year, please enter 0)
77
7th Child's Grade
Not in School
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
78
Would you like us to change 7th child's diaper?
YESNO
79
Allergies or things you want 7th child to avoid
80
Other Comments/Instructions for 7th Child
Huge
Large
Normal
Small
Ok
Ok
81
Would you like to register another child?
YESNO
82
8th Child's Name
First Name
Last Name
83
8th Child's Nickname(Skip if not applicable)
84
8th Child's Relation to 1st Child
85
8th Child's Birthday
Date
Year
Month
Day
86
8th Child's Age(If under 1 year, please enter 0)
87
8th Child's Grade
Not in School
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
88
Would you like us to change 8th child's diaper?
YESNO
89
Allergies or things you want 8th child to avoid
90
Other Comments/Instructions for 8th Child
Huge
Large
Normal
Small
Ok
Ok
91
Would you like to register another child?
YESNO
92
9th Child's Name
First Name
Last Name
93
9th Child's Nickname(Skip if not applicable)
94
9th Child's Relation to 1st Child
95
9th Child's Birthday
Date
Year
Month
Day
96
9th Child's Age(If under 1 year, please enter 0)
97
9th Child's Grade
Not in School
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
98
Would you like us to change 9th child's diaper?
YESNO
99
Allergies or things you want 9th child to avoid
100
Other Comments/Instructions for 9th Child
Huge
Large
Normal
Small
Ok
Ok
101
Who is authorized to pick up your child(ren) besides the parents/guardian listed above?(Leave blank if none)
102
Restoration Church recognizes the need to ensure the welfare and safety of all young people taking part in any activity associated with our church. We pre-screen all of our teachers and work hard to maintain a clean, safe facility.

Please note that your child's photograph may be taken during his/her time with us. It is likely these images will be used as: a record of the event, a post on our private Facebook page for parents only, or as publicity material for future activities or events. We will take steps to ensure that these photos are used solely for the purposes they are intended. If there is a reason your child should not be photographed, please send an email to contact@mfcministries.net stating such information.

We look forward to partnering with you on your child's journey!
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