Child's Name
Parent/Guardian Name

(this is the phone number we will contact you at in case of emergency or otherwise)

(NOTE: Toddlers [3-4 years old] MUST be potty trained; space limited)

(please tell us the last grade your child completed)

(important medical information we need to know. Example: any allergies, etc)
Emergency Contact Name

(this is the phone number we will contact you at in case of emergency or otherwise)

(who will/may pick up your child at the end of each day. If different from parent/guardian, please put name and contact number in this field)

(does your child attend church? If so, where?)

(If your child is visiting our church, who is he/she a guest of?)
We take photographs during the event for social media posts and sharing. If you would prefer to OPT OUT of photography of your child(ren), please check the box below.