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Registro en Español

Cornerstone Presbyterian Church

Location

1000 3rd St NE

Minot, ND 58703

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Contact Christine Main:

701-852-0315

christine.cornerstoneminot@gmail.com

First, Tell Us About Yourself:

Parent Information

First Name

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Last Name

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Address 1

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Address 2

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City

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State/Province

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ZIP/Postal Code

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Country

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Text Message Phone

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Contact Phone 2

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Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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Home Church Affiliation

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By submitting this form, you are consenting to Cornerstone Presbyterian Church to photograph and video your child, and utilize photos and videos for promotional usage. If you do not consent, please note that in the comments.

Comments

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Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

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Tell Us About Your Participant

First Name

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Last Name

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Grade Entering

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Gender

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Date Of Birth

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Allergies

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Medical Concerns

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Do you have friends you would like to be placed with? We will do our best to group selected friends together in the same crew, but we cannot promise all requests will be possible.

Friend 1 First Name

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Friend 1 Last Name

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Friend 2 First Name

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Friend 2 Last Name

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Friend 3 First Name

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Friend 3 Last Name

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Comments

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