Connect Kids Sign Up • Connection Christian Church

Thanks for your interest in signing up for Connect Kids!

Save time by filling out this form prior to your first visit!

We Can't Wait to Serve your Family!

First Name

Last Name

Preferred Name

Date of Birth

Child's School Grade Grade? *

Parent/Guardians Name(s)

Phone Number *

Parent's Email Address *

Home Address

Home Address Line 2

Home City

Home State

Home Zip Code

Allergies

Is your child potty trained?

Do you give volunteers in Connect Kids permission to change your child's diaper? All diaper changes will be attended by 2 volunteers.

Special Instructions with potty training and/or diapering?

Are there any special needs Connect Kids needs to be aware of? If yes please explain.