About You

Your Name

Your Email Address

Your Telephone

Class Choice

For which class(es) are you registering your child/children (check all that apply):
 DiscoverU Sundays - 9 to 10:30am DiscoverU Wednesdays - 6:30 to 8pm

When Will You Serve?

To ensure child safety and to ensure we have the volunteers required to provide quality opportunities for the children at FCC, we will need you to serve at least one time during these thirteen weeks.

If you are registering for a Sunday class, select a Sunday date to serve. If you are registering for a Wednesday class, select a Wednesday date to serve. If you are registering for both, please select a date from both Sunday and Wednesday.

Sunday Serving | ---January 8January 15January 22January 29February 5February 12February 19February 26March 4March 11March 18March 25April 1
Wednesday Serving | ---January 11January 18January 25February 1February 8February 15February 22February 29March 7March 14March 21March 28April 4

About Your Children

First Child

Full Name

Gender
 Male Female
Date of Birth

Grade

Allergies

Second Child

Full Name

Gender
 Male Female
Date of Birth

Grade

Allergies

Third Child

Full Name

Gender
 Male Female
Date of Birth

Grade

Allergies

Fourth Child

Full Name

Gender
 Male Female
Date of Birth

Grade

Allergies

In An Emergency

In the event of an emergency, I authorize first aid or medical treatment for this child and I release First Christian Church from any and all responsibility in connection therewith. (This is required for online DiscoverU registration.)

Help with Breakfast Costs

Providing breakfast for the youngsters is a pleasure, but it does take some financial resource. Would you like information on helping us fund the meals that the children receive?
 Yes No

Anything Else?