Serve with our Kids & Youth

Name*
First Last
Alias/Maiden Name
Date of Birth*
Date Format: MM slash DD slash YYYY
Phone*
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Where are you interested in serving?*
- Yellow Room (0-23 mths)
- Orange Room (2-3 years)
- Blue Room (3-4 years)
- Green Room (4-6 years/Pre-K)
- Elementary (K-5th grade)
- Host (Check-In)
- Alive Youth Church (6th-12th grade)
Church History
Where have you previously attended church?
Church Name*
How long did you attend?*
Contact*
First Last
Church's Phone*
Church's Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Personal Reference #1
(Non-Related)
Name*
First Last
Relationship*
Phone*
Email*
Personal Reference #2
(Non-Related)
Name*
First Last
Relationship*
Phone*
Email*
Background Check
I authorize West Salem Foursquare Church to perform a background check on me.*
- Yes
Thanks for your interest in serving!
Once you have completed registration, we will contact you within the week to answer any questions you may have.

Church History