2026-2027 Centerpoint Kids Registration Form

CENTERPOINT KIDS' CHURCH RETURNS FROM SUMMER BREAK ON SEPTEMBER 6, 2026!

Register each of your children below.

2026-2027 Classrooms
Room 10: Nursery and Preschool
Room 4: K-2nd Grade
Room 6/7: 3rd-5th Grade

First Parent/Guardian Name:

Email:

This address will receive a confirmation email

Cell Phone

Home Phone

Address:

Second Parent/Guardian Name:

First Child's Name:

Birthdate:

Grade (2026-2027):

Any allergies?

Please list anything in this box that will help us better understand your child while we have them in class. This information will be kept confidential and is only used to help us get to know your child better. (physical disabilities, developmental delays, fears, favorites, IEP, nickname, etc)

Second Child's Name

Birthdate

Grade (2026-2027)

Any Allergies?

Third Child's Name:

Birthdate:

Grade (2026-2027):

Any Allergies?

Fourth Child's Name:

Birthdate:

Grade (2026-2027)

Any Allergies?

Photo Release -I hereby consent to and authorize the use and reproduction by CCC Salem of any and all photographs that have been taken of me and/or my child(ren) for use on our web site, Facebook page, and/or directory. I acknowledge that I have read and understood the terms of this release.

Yes Yes, but please don't use my child(children)'s names No

See you in church!

Description

Please use this form to register for kids' church (Preschool-grade 5) at Centerpoint Community Church, Salem, NH.

2026-2027 Centerpoint Kids Registration Form

Description

Please Fix the Following