Family Check-In Pre-Registration | Brookhaven Wesleyan Church

This will help us have your information prior to you checking in at Brookhaven Wesleyan Church with your children. This will allow for a faster process for your family on Sunday morning.

Parent 1 - First & Last Name

*

Email

*

This address will receive a confirmation email

Parent Information

Please provide current information for both parents if applicable

Parent 2 - Name

Email

Address

*

Primary Contact Phone (Cell Phone Preferred)

*

What service will you be attending?

*

Please select all that apply.

9:00 AM (No KidMin Offered) 10:00 AM 11:00 AM

How did you hear about Brookhaven Wesleyan Church?

*

Children Information

Please provide the following information for all children in your household

Name of Child (1st)

*

Gender

*

Please select all that apply.

Male Female

Birthdate

*

Current Grade Level (if applicable)

Any Allergies?

*

Name of Child (2nd)

Gender

Please select one option.

Male Female

Birthdate

Current Grade Level (if applicable)

Any Allergies?

Name of Child (3rd)

Gender

Please select one option.

Male Female

Birthdate

Current Grade Level (if applicable)

Any Allergies?

Name of Child (4th)

Gender

Please select all that apply.

Male Female

Birthdate

Current Grade Level (if applicable)

Any Allergies?

Name of Child (5th)

Gender

Please select all that apply.

Male Female

Birthdate

Current Grade Level (if applicable)

Any Allergies?

Name of Child (6th)

Gender

Please select all that apply.

Male Female

Birthdate

Current Grade Level (if applicable)

Any Allergies?

Name of Child (7th)

Gender

Please select one option.

Male Female

Birthdate

Current Grade Level (if applicable)

Any Allergies?

Question / Comments

Description

This will help us have your information prior to you checking in at Brookhaven Wesleyan Church with your children. This will allow for a faster process for your family on Sunday morning.

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