JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Participant Registration for Wednesday Night Alive 2021
Use this form to register children for Wednesday Night Alive Summer 2021.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Parent/Guardian #1 Name
*
Your answer
Parent/Guardian #1 Cell Phone Number
*
Your answer
Parent/Guardian #1 Home Address
*
Your answer
Parent/Guardian #2 Name
Your answer
Parent/Guardian #2 Cell Phone Number
Your answer
Parent/Guardian #2 Home Address (if different than Parent/Guardian #1's address)
Your answer
Parent/Guardian #2 Email Address
Your answer
How many children do you have between the ages of 5-12?
*
Children between the ages of 5-12 will be participants in Wednesday Night Alive.
1
2
3
4
5
How many teens do you have who are age 13+?
*
0
1
2
3
Wednesday Night Alive is scheduled to begin at 5 PM and end at 8 PM each week. Can you ensure that your children will arrive at 5 PM and be picked up by 8 PM each week?
*
Yes
No
Other:
Please check ALL weeks that you "think" your children will be able to attend Wednesday Night Alive.
*
June 23
June 30
July 7
July 14
July 21
July 28
August 4
August 11
Required
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Trinityworc.org.
Report Abuse
Forms
