If you are new to Carlisle Brethren in Christ or if you have been calling our church your home for several years, we ask that you fill out the required information below. This will give us the best possible opportunity to care for your children in a safe, healthy and secure environment.

Just click the "Submit Form" button below when you are finished and a confidential form will be sent to our Director of Children's Ministry, Jane Beachy and her assistant Deb Denlinger.

Parent Information

  Last Name          Phone Number

  Father's Name    Mother's Name

 E-mail Address

 Complete Address (City/State/Zip)

In case of an emergency we will make every effort to contact the child's parent or guardian. In the unlikely event that those people cannot be reached, will you give us permission to pursue emergency treatment for the child listed below?  

 Full name of person giving permission

In case of an accident, will you release Carlisle Brethren in Christ Church and staff/volunteers from any and all liabilities? 

 Full name of person giving release

Child Information
(You will need to submit a Family information sheet for EACH child)

 Last Name of Child   Child's First Name

 Date of Birth       Grade

 Special Needs/Medical Considerations

 Names of people NOT allowed to pick up children
for any reason

 
If you would like to have anyone other than the persons listed above in the "Parent Information" section pick up your child from class, you must give us their information below:

 Name  Relationship

 Phone Number

 Name  Relationship

 Phone Number