Child's Name:*
Parent / Guardian Name:*
Cell Phone:*
Birth Date:*
Last Grade Completed by your Child? *
List ANY Medical / Food Allergies we may need to know.
Emergency Contact Name:*
Emergency Contact Phone:*
Please Indicate names of those who may pick up your child at the end of each night. *
Does your Child attend Sunday School?*
If YES, Where?
Is your child visiting our church?
If YES, who is your child a guest of?
May We Photograph your child*
If YES, may we put photos of your child on Social Media?*
Word Verification: