Children and Youth 2025 2026

See you at Centenary!

Student's Name

*

Age or Grade

*

Please select all that apply.

< 1 year old 1 year old 2 years old 3 years old 4 years old 5 years old Rising Kindergarten Rising 1st Grade Rising 2nd Grade Rising 3rd Grade Rising 4th Grade Rising 5th Grade Rising 6th Grade Rising 7th Grade Rising 8th Grade Rising 9th Grade Rising 10th Grade Rising 11th Grade Rising 12th Grade

Child's Date of Birth

*

Gender

*

Please select one option.

male female

Parent/Guardian's Name

*

Email

*

This address will receive a confirmation email

Phone

*

Authorized person to pickup child if other than parent/guardian listed above.

Address

*

Emergency Contact Name and Phone

*

Allergies, medical, behavioral or custodial information

*

Current student at Centenary Preschool?

*

Please select one option.

Yes No

Current participant in Boys and Girls Club?

*

Please select one option.

Yes No

Church

*

Please select one option.

Centenary Methodist Church Other church Do not have a church home

Release

*

Please select all that apply.

I release Centenary Methodist Church, its members, denomination, staff and volunteers from liability.

Photo

*

Please select all that apply.

My child can be photographed/videoed as a part of church events. My child cannot be photographed/videoed as a part of church events.

My student would like to:

Please select all that apply.

be in performing arts (music, drama) be an acolyte (K-6th grade) help with the tech team (audio/visual) (7th-12th grade) help with community meals do an elem/middle mission trip (3rd to 6th grade) do a youth mission trip (7th-12th grade) read scripture during children's moments go to summer camp (K-12th) be in Sunday school Eagle Sky Overnight Camp (pay deposit of $50 to guarantee a spot) - mid July

As a parent/guardians I can:

*

Please select all that apply.

Help with Sunday school Help with children's church Help with children's moments Chaperone field trips Donate supplies Donate scholarships Help with the children's library Chaperone mission trips Help with Bible school Help with acolytes

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

See you at Centenary!

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