FPU Childcare Registration

Registration only needs to be completed for one family member attending the class. Please provide the appropriate answers below for an additional family member.

*Address Line 1
Address Line 2
*City
*State/Province/Region
*Zip/Postal Code
*Attendee's Gender:
*Attendee's Birthday:
*Attendee's Marital Status:
*Will there be another family member attending with you?:
Addt'l Family Member's First & Last Name:
Addt'l Family Member Gender:
Addt'l Family Member's Birthday:
Addt'l Family Member's Mobile #:

Childcare reservations are required for all weekly FPU. Central Kids programming is provided free of charge for children who are six weeks old through 5th Grade.

*Do you need childcare for the weekly classes?:
Do you agree to allow Central Christian Church to use photos, videos or statements of your child in church-created publications, media releases, information displays, websites, social media and/or other electronic media. No personal address, phone number or email address will be included. Please answer Yes or No for each child that will be in our care during this event.:
Child #1 First & Last Name:
Child #1 Gender:
Child #1 Birthday (mm/dd/yyyy):
Child #1 Grade (if applicable):
Child #1 Allergy / Special Need:
Child #1 Photo/Media Release:
Child #2 First & Last Name:
Child #2 Gender:
Child #2 Birthday (mm/dd/yyyy):
Child #2 Grade (if applicable):
Child #2 Allergy / Special Need:
Child #2 Photo/Media Release:
Child #3 First & Last Name:
Child #3 Gender:
Child #3 Birthday (mm/dd/yyyy):
Child #3 Grade (if applicable):
Child #3 Allergy / Special Need:
Child #3 Photo/Media Release:
Child #4 First & Last Name:
Child #4 Gender:
Child #4 Birthday (mm/dd/yyyy):
Child #4 Grade (if applicable):
Child #4 Allergy / Special Need:
Child #4 Photo/Media Release: