theRefuge Church - Lakeland, TN - CCH Childcare Registration

Christmas Coffee House Childcare Registration

Registration is open through Dec 6th. You must provide name and ages of children you want to register.

Parent's First Name:
Parent's Last Name:
Phone Number:	() -Second partThird part
Email Address:
1st Child's Name:
1st Child's Age:
2nd Child's Name:
2nd Child's Age:
3rd Child's Name:
3rd Child's Age:
4th Child's Name:
4th Child's Age:
5th Child's Name:
5th Child's Age: