Welcome to Westside Family Church. By completing this form we can input your family's information in the children's check-in system prior to Sunday's service. Bring the confirmation page to the new family desk and we will have a barcode and information package ready for you.

Contact Donna Fulton at Dfulton@Westsidefamilychurch.com with registration questions.

Family Last Name *

Last Name of Head of Household

Email Address *

Contact Phone *

Contact Phone

NOTE: The last FOUR digits of this phone number will appear on the pager board during service if we need you. This phone number can be used at the kiosk to check-in your children.

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Cell Phone Number

You number can help us contact you regarding your children or church event information.

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Cell Phone Provider

Enter the provider for your cell phone. IE.. AT&T, Sprint, Verizon, T-Mobil, etc.

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Contact Name

First and Last Name - If parent label is misplaced a picture ID will need to be produced to verify identity.

First Name

Last Name

Primary Contact Gender

Primary Contact Birth Day

YYYY

Spouse/Adult Name

First and Last Name - If parent label is misplaced a picture ID will need to be produced to verify identity.

First Name

Last Name

Spouse/Adult 2 Gender

Child 1 Info

Child 1 Name

First Name

Last Name

Child 1 Gender

Child 1 Birth Day

Please double check the year of birth entry before submitting, we want to make sure your child will be assigned to the correct location.

YYYY

Child 1 Development/Grade

Child 1 Allergies/Special Needs

Please list any allergy or special needs our teachers should be aware of.

Child 2 Information

Child 2 Name

First Name

Last Name

Child 2 Gender

Child 2 Birth Day

Please double check the year of birth entry before submitting, we want to make sure your child will be assigned to the correct location.

YYYY

Child 2 Development/Grade

Child 2 Allergies/Special Needs

Please list any allergy or special needs our teachers should be aware of.

Child 3 Name

First Name

Last Name

Child 3 Gender

Child 3 Birth Day

Please double check the year of birth entry before submitting, we want to make sure your child will be assigned to the correct location.

YYYY

Child 3 Development/Grade

Child 3 Allergies/Special Needs

Please list any allergy or special needs our teachers should be aware of.

Child 4 Information

Child 4 Name

First Name

Last Name

Child 4 Gender

Child 4 Birth Day

Please double check the year of birth entry before submitting, we want to make sure your child will be assigned to the correct location.

YYYY

Child 4 Development/Grade

Child 4 Allergies/Special Needs

Please list any allergy or special needs our teachers should be aware of.