Children's Ministry
Hopkinsville Cumberland Presbyterian Church
Coming Soon:

Bible School will be in June 1 - 4, 2021

​5:45 - 8:00
Ramsey
Sierra
Ava
Lawrence
Finn
Preschool
Billy
The characters to look for at the Rocky Railway

Registration Form
(One per child)



Child's name: _______________________________ Child's gender: ___________

Child's age:  ______  Date of birth: __________ Last school grade completed: ____

Name of parents:  ____________________________________________________ 

Street address:  ______________________________________________________ 

City:  ________________________  State:  ______________  Zip:  _________ 

Home telephone (____)   ______________________

Parent/caregiver's cellphone:  (____) _________________

Home email address:  _________________________________________________ 

Home Church:  _______________________________________________________ 

Allergies, medical conditions, or special needs:  _____________________________ 

                        In case of emergency, contact: _______________________________ 

                        Phone:  _________________________________________________ 

                        Relationship to child:  ______________________________________ 

Crew number or name (for Church use only)  _________________________________ 
 


Print form and complete, bring with you on June 1 at 5:45