Super Church Registration Form
Information received is confidential and is being gathered for the purposes of enrolling your child in our programs, to assign the student to the appropriate classes, to develop and nurture ongoing relationships with you and your child, and to inform you of program updates and upcoming opportunities at Calvary Pentecostal Temple. Any medical information collected here serves to authorize Calvary Pentecostal Temple, and its staff and volunteers, to obtain medical assistance in emergencies. This information will be maintained indefinitely as it is a requirement of our insurance company. If you wish Calvary Pentecostal Temple to limit the information collected, or to view your child's information, please contact us.

Personal Information
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  • Emergency Contact Information

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  • Authorized People to Sign Out Child

    Other than parents (includes older siblings, grandparents, etc)
  • Medical Information

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