2025/2026 GEMS Wednesday Children's Ministry

Childs Name

Childs Date of Birth

Parent/Guardian 1 Name

Parent/Guardian 1 Preferred Phone Number

Parent/Guardian 2 Name

Parent/Guardian 2 Preferred Phone Number

Parent/Guardian Address

Parent/Guardian Email Address

This address will receive a confirmation email

Please explain any special needs, allergies/medical needs for your child.

Current Grade Level

Birth - 1 year Toddler 2-3 Age 4 - Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5

Description

For girls who will be attending GEMS on Wednesday evenings.

Please fill out this form and click submit.