EPA Child / Student Registration Form

Elmira Pentecostal Assembly (EPA) is collecting and retaining this personal information for the purpose 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 our church. This information will be maintained permanently as it is a requirement of our insurance company and legal counsel. If you wish Elmira Pentecostal Assembly to limit the information collected, or to view your child’s information, please contact us.


Thank you for taking the time to register your student!