Children on Mission Complete the form to enroll your child in children’s ministry on mission. Contact inscrire enfant english Child's name Child's name First name First name Last name Last name Sexe * Your choiceFeminineMale month of birth * Parent 1 * Your choicemotherfather Name * Name First name First name Last name Last name Email * Phone * Parent 2 Your choicemotherfather Name * Name First name First name Last name Last name Email * Phone * Specific health issues No diseaseDiabetesEpilepsyAsthmaBehavioral issues Does your child require special care? * Your choiceYesNo If yes, which ones? Allergies Need an epipen? * Your choiceYesNo In the event of an emergency, I authorize Ministry officials to administer epipen to my child as needed Your choiceYesNo *IT IS MANDATORY TO PROVIDE YOUR CHILD'S EPIPEN IF THEY HAVE SEVERE ALLERGIES REQUIRING THE USE OF AN EPIPEN. If you are human, leave this field blank. Send Δ
