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HARBOR LIGHT GIRLS MINISTRIES ON-LINE REGISTRATION

 Welcome to Harbor Light Girls Ministries - we are so excited to have you join us this year! 

Club: 

Child's Name:    

Street Address: 

 City, State, Zip 

Home Phone:    

Mother's Name:   

Mother's Cell: 

Fathre's Name:  

Father's Cell: 

Child's Birth Date: 

Parent's Email Address: 

Home Church: 

Has your child asked Jesus into her heart? YES  NO

Has your child been baptized in water? YES  NO

Children are highly valued at Harbor Light Girls Ministries and we want to keep them safe.  Club meetings end at 7:45 p.m. so please come to your child's classroom to pick him/her up personally by 8:00 p.m.  If preferred, a sibling in high school or another adult may be designated below; without this form on file, children will only be released to their parents.

Please release my child from Missionettes to either the following person(s) or myself:

(Name, Relationship, Phone ) 

(Name, Relationship, Phone ) 

During Clubs, I am usually:

 On Campus   Off Campus and can be reached at:

This registration form will be sent directly to Children's Ministries once you hit the SUBMIT button.  A Parental Consent and Medical Release form is also needed, please request one from your Missionette Leader on the first night of Clubs.

 If you have any questions, you may email Children@harborlight.com or call (510) 744-2222.