First Name:  * Middle Name Last Name:  * Birthdate Address: City: State: Zip Code: Email Address:  * Home phone  * Cell phone Name as you wish it to appear on a nametag:  * Phone number you would like published in our member directory (For church use only. Will not be shared outside of congregation) Marital Status Single Married Spouse's Name Is your spouse also registering for this class? Yes No Spouse's nametag Spouse Email address Spouse's Birthdate Spouse's cell phone Information regarding children Children's names ages and school grades. Please indicate whether or not your children have been baptized Will you need childcare for this class? Yes No If childcare is needed please list the names and ages of children needing care Please list the name address and phone number of an emergency contact person How did you hear about WHPC? How long have you been visiting or participating at WHPC? Which worship service do you normally attend 8:15 a.m. 9:30 a.m. 11:00 a.m. List past church involvement or leadership positions Have you ever been ordained in PCUSA as a Deacon or Elder? YesNo If yes to what office were you ordained? DeaconElderBoth List talents and hobbies you might be willing to share with the church Have you been baptized either as an infant or an adult? YesNo Has your spouse been baptized either as an infant or adult? YesNo Write a brief profile of yourself: A few words about your hobbies family job etc. Should you decide to join this information will appear along with your photograph in the church's monthly newsletter the Echo. EXAMPLE: James and Susan Smith have two daughters Tammy (7) a second grader at Trinity Episcopal and Jane (4) a preschool student at Elsass Academy. Susan practices family law and James is retired from the military service and is helping to support his family as a stay-at-home parent. Security code:   * Do not enter anything in this field: