Family Pre-Registration

We love helping children develop a genuine love for Jesus, building their lives on the truth of God's Word, connecting in meaningful friendships, and discovering their purpose at a young age.

Our team will be waiting at the first-time check-in station, where you can tell us a little about your family. To prepare ahead of time, you can fill out the New Family Pre-Registration Form. Check out times and locations to join us for a Sunday service.

Your name *

Last name

Email address *

Planned Visit Date

Adult Infomration

First Name

Last Name

Gender

Birthdate

Marital Status

Phone number *

Phone type

Second Adult

First Name

Last Name

Gender

Birthdate

Marital Status

Mobile Phone

Address

Country

Street Address

Apt/unit/box (optional)

City

State

Postal code

Children

Household members

Additional Medical Notes

Are there any additional medical conditions we should be aware of? If there are none, please leave them blank.

Allergy

Are there any allergies we should be aware of? If there are none, please leave them blank.

Eggs

Food Dyes

Gluten

Insects / Ants / Wasps / Bees / Mosquitoes

Milk / Dairy

Latex

Peanuts

Tree Nuts

Soy

Other

Additional Allergy

Are there any additional allergies we should be aware of? If there are none, please leave them blank.

Legal notes

Are there any important legal information about the child (i.e. custody restrictions) we should know about, if none, please leave it blank.

We often have photographers capturing moments at Riverside, so if you'd prefer to make sure we don't capture you (or your guests), just let us know.

I prefer not to have my or my child(ren)'s picture captured.

I do not mind having my or my child(ren)'s picture captured.

Security Claim Acknowledgement *

For security purposes, I understand that I must present the security claim tag assigned to me or a valid Photo ID in order to obtain my child(ren) from Riverside Kids / Preschool once they are checked in.

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Riverside Church
info@riverside-church.com
269-273-8723

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Check-In Sermons: Worship Service Home Profile