Wirth Middle Focus Point Registration Form
Who: Wirth Middle 6th & 7th Grade Students

What: A non-denominational Bible based after-school program

When:  Wednesdays - April 10th, 17th, 24th and May 1st, 2024    After School *3:15 until 4:45pm

Where: We will meet in the 7th grade Cafeteria
           
Why: We teach the truth & hope found in the Bible. This basic foundation of faith will help children their entire lives.

How: Submit 1 registration form below for each child attending or print and complete the paper registration form and return to the Coordinator.


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Wirth Middle Registration Form Spring 2024
Child's First Name *
Child's Last Name *
Grade Level *
School Teacher *
Parent/Guardian Name *
Street Address *
Home Phone Number
Cell Phone Number
Email Address
Emergency Contact Name and Phone Number (3:15pm-4:45pm) *
Allergies/Special Concerns *
Required
If yes, please explain
I would like to:
Does your child have a bible at home?
By typing my name below, I give my child permission to attend the after-school Kids For Christ Bible Study. I assume all risks and hazards incidental to Bible Study participation.  *
Required
Parent Signature *
Date Signed *
MM
/
DD
/
YYYY
This program is entirely voluntary and not affiliated with School District #187.

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