Shiloh Middle J.A.M. ( Jesus and Me) Registration Form

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Who: Shiloh Middle School students 4th through 8th Grade

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

When: Monday April 8th, 15th, 22nd and 29th after school until 4:30 pm

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.

Email *

Shiloh JAM Registration Form Spring 2024

Child's First Name *

Child's Last Name *

Grade *

School Teacher *

Parent/Guardian Name *

Street Address *

Home Phone Number

Cell Phone Number

Email Address

Emergency Contact Name and Phone Number (3pm-4:30pm) *

Allergies/Special Concerns *

Yes

Required

If yes, please explain

I would like to:

Volunteer

Donate Snacks

Does your child have a bible at home?

Yes

Please check if you DO NOT want a photo of your child to be used in newspaper articles, newsletters, or on the Kids For Christ Website or facebook page.

By signing this form I give my permission for my child to attend the after-school Bible Study. I understand that all topics and answers will be Biblically based. I assume all risks and hazards to Bible study participation. *

I agree to the statement above.

Required

Parent Signature *

Date Signed *

YYYY

This Program is entirely voluntary and not affiliated with School District #85

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