Kids First Registration Form

Kids First MDO Registration Form

Student Name *

Birthdate *

Mailing Address *

City *

State *

Zip *

PARENT INFORMATION

Preferred CONTACT Person *

Contact # *

Preferred E-Mail *

Mother *

Occupation *

Cell Phone *

E-Mail *

Work # *

Father *

Occupation *

Cell Phone *

E-Mail *

Work # *

EMERGENCY CONTACTS

1) Name *

Cell Phone *

2) Name *

Cell Phone *

3) Name *

Cell Phone *

List Other Children in Family

Name *

Age *

Name *

Age *

Is your child receiving any special services? Describe

Yes *

NO *

What church do you currently attend? *

Non-Refundable Registration Fee $150: Make check payable to FUMC-DS MDO
Mail payments: 316 Centerville Street, NW, Denham Springs, LA. 70726
OR Drop off in locked mail box at Office entrance.

Submit

Worship Times:

Traditional Worship:
8:30 am
In the Sanctuary

Sunday School (All Ages)
9:30 a.m.
In the Education Wing

Crossroads Worship:
10:30 am
In the Crossroads Worship Center

Hours

M-Th: 8:30 am-5pm
Friday: 9:oo am- 12pm

Telephone

225-665-8995

Email

office@fumc-ds.org