Kids Ministry Registration Form | Glory Church Pike County

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Child Registration Form

Parent/Guardian's First Name

Parent/Guardian's Last Name

Mailing Address

Email

Phone

Child's First and Last Name

Chid's Date of Birth

Current Grade in School

Please list any allergies below.

Please list any dietary restrictions below.

Please list any medical or behavioral considerations for your child(ren) below.

My permission is granted for Glory Church and its staff and volunteers to obtain necessary medical attention in case of sickness or injury to my child.

I understand that my child may be photographed or videotaped while participating in the activities and events sponsored by Glory Church, and give my permission and consent to allow these photographs or videotapes to be used in promotional materials.

Thank you!

Get in Touch

Mail: P.O. Box 3259, Pikeville, KY 41502

Email: glorychurchpike@gmail.com

Online Connect Card

Online Giving Page

Gathering Times

Sunday Mornings - 11 AM at 231 Redale Road

Nursery and family courtesy area available

Wednesday Nights - 6:30 PM at 231 Redale Road

© 2021- 2024 Glory Church

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