Walking With Purpose Registration

Walking With Purpose Registration 2013/2014

________________________________________

Registration Type

Registrant's Name

First NameLast Name

Date of Birth

(ex. 05/21/65)

Home Phone number

Cell Phone number

Primary Contact E-Mail Addr.:

No E-mail? enter none@none.com

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Emergency Contact

First NameLast Name

Emer. Contact Phone

______________________________________________________________________________________

Course Description

WWP 101: Choosing The Better Part - Choosing the Better Part touches on all aspects of faith and encourages us to deepen our relationship with Christ ... Read More

Beholding His Glory - a twenty-two session course, shows us how all Scripture points us to our Redeemer, Jesus Christ. Beholding ... Read More

______________________________________________________________________________________

Select your Course

Select your Session Time

Do you need Childcare?

Registration Fee

Payment Method

______________________________________________________________________________________

**Online Payment- As a parishioner of St. Christopher's Church, you can pay online via the secured, encrypted Parish Financial Tool called "Online Giving". Payments are processed like a bill payer service and are debited from your bank account as you schedule it. No Credit or Debit Cards are accepted at this time. Online Payment Instructions

______________________________________________________________________________________

How many children are you re-enrolling?

Child #1 Name

First NameLast Name

Child #1 Gender

Child#1 Age in Fall

Child#1 Potty Trained?

Child#1 - Allergies/Medical Condition or Any Information we should know.

______________________________________________________________________________________

Child #2 Name

First NameLast Name

Child #2 Gender

Child#2 Age in the Fall

Child#2 Potty Trained?

Child#2 - Allergies/Medical Condition or Any Information we should know.

______________________________________________________________________________________

Child #3 Name

First NameLast Name

Child #3 Gender

Child#3 Age in the Fall

Child#3 Potty Trained?

Child#3 - Allergies/Medical Condition or Any Information we should know.

______________________________________________________________________________________

Child #4 Name

First NameLast Name

Child #4 Gender

Child#4 Age in the Fall

Child#4 PottyT rained?

Child#4 - Allergies/Medical Condition or Any Information we should know.

Comments & Requests?

____________________________________________________________________________________

Administrative use ONLY

Payment Received

Materials Delivered

____________________________________________________________________________________

Complete Registration

1. Press "Print Form" for your records.
2. Press "Submit Form". We will receive your enrollment electronically.

Childcare Registration