Childcare Registration Form

Childcare is provided for infants and children up to age 11 only.

How many children will you need care for?*

Parent 1 Name*

Parent 2 Name

(*Please keep your phone on vibrate during sessions)

Cell Phone Number*

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Home Phone Number

Email*

Home Address

Church Selection:*

*Important: You are welcome to provide your own snacks and/or lunch for your child, but please note that Purpose Church is a nut-free facility (no peanuts, peanut butter, almonds, other nuts or nut products).

Specific Food Allergies (if applicable):

Specify special needs for child/ren (if any)

Will your child nap during the time he/she is in childcare? (Give time and special instructions)*

THURSDAY, October 19th (Childcare will open at 7:30 a.m, and 15 minutes before each event)

Indicate event/s child care needed*

TM Business and Breakfast Meeting (8:00AM - 9:45AM)
Opening General Session (10:00AM - 12:00PM)
Lunch Break (12:00PM - 1:30PM)
Tracks - Part I & II (1:30PM - 4:00PM)
Pre-Dinner Appetizer Hour (4:10PM - 5:00PM)
Evening General Session (6:30PM - 8:00PM)

*Note: Childcare closed during dinner.

FRIDAY, October 20 (Childcare will open at 8:30 a.m., and 15 minutes before each event)

Indicate event/s child care needed*

Morning General Session (9:00AM - 11:00AM)
Breakouts (11:00AM - 12:30PM)
Lunch Break (12:30PM - 2:00PM)
Closing General Session (2:00PM - 3:30PM)

NOTE: Please pick up your child promptly after each event.
You may be asked to present identification at the time of pick up.

Contact information: 970 South Village Oaks Drive, Suite 101 Covina, CA 97124
Michele Chapman at [email protected], or call 626.408.3877

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