Check one:

  First & Last Name:

  Spouse's Name (if applicable):

 Address:

 City/State/Zip:

 E-mail:

 Phone:

 Who will be serving in the nursery?

 Which Sunday of the month
 would you like to serve?

 Which service would
you like to serve?

 Which age group would
you like to serve?

  Infants  Walkers  Toddler 2's

If you have children under the age of