CHILDREN'S REGISTRATION 2011-2012
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Curtains Up!: Grades 3-6 | Tuesdays, 4:30 — 5:30 p.m. | Room 207
Junior Bells: Grades 3 and up | Sundays, 12:15 - 1 p.m. | Room 204


 Parents’ Last Name

 Parents' First Names

 Home Address

 City State Zip

 Phones: Home Work (optional) Cell (optional)

 Email

Emergency contact: Name

Phone Cell

Do you attend church at Valley? Yes, member                    Yes, regular attender

                                                Yes, occasional attender   No

 I am registering my child(ren) for:

Curtains Up!

     Child’s name   Grade   Allergies

Junior Bells:

     Child’s name   Grade   Allergies




Enter the numbers as they
are shown in the image above

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