Devoted Life Wednesday Nights Childcare Registration - WITNESS

MAY REGISTRATION (Witness)

PARENT INFO

Parent's Name

This address will receive a confirmation email

Phone

Please choose which night(s) you are needing childcare.

May 6th Dinner & Discussion Night May 20th Praise & Prayer Night

CHILD INFO

Please list names and ages of the children you are registering.

Please list any allergies or special needs your child/children may have.

Consider donating to help cover babysitting fees:

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Please fill out this form and click submit.