Crossroads Church Palm Harbor

Registration

Welcome to Legacy Kids Ministry. Please use this online form to register your children to attend our programs and events.

Parent/Guardian(s) Name (First and Last)

Address

Child's Name (First and Last)

Child's Date of Birth

Parent Email Address

Parent Cell Phone Number

Medical or Other Important Information (Including Allergies)

Emergency Contact Name and Phone Number (If Different than Parent/Guardian)

Alternate Pickup Person(s) Name and Email:

Name of Ministry or Event your child will attend

From time to time, we take photos or videos of our church activities and they may appear on our website or social media pages. We do not provide any specific information regarding minors. If you would like to withhold photo permission for your child, please check the box below.

No, I do not give Legacy Church permission to use photos or Videos of my child.

Thank you for Registering!