Roosevelt Kids For Christ Registration Form Spring 2024
Who: Roosevelt Elementary Students Kindergarten through 6th Grade

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

When: Tuesdays,  April 9th, 16th, 23rd and 30th from 2:55 - 4:30 pm.4 weeks. We will have a closing program on the last evening, April 30th at 4:15pm. 

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 registration form and return to the Coordinator. Do not forget to hit "submit" at the end of the form. Any questions, contact Jane Peters-618-406-7607


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Roosevelt Kids For Christ Registration Form Spring 2024
#1Child's First Name *
#1 Child's Last Name *
Grade *
School Teacher *
#2 Sibling's First/Last name
Grade
Clear selection
#2 Teacher's Name
#3 Sibling's First and Last Name
Grade
Clear selection
#3 Teacher's Name
Parent/Guardian Name *
Street Address and zip *
Cell/Home Phone Number *
Email Address
Emergency Contact Name and Phone Number (3pm-4:30pm) *
Allergies/Special Concerns *
Required
If yes, please explain for each child
Will your child go to latchkey after Kids For Christ *
Required
Will your child walk home? *
Required
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 understand I must confirm all Bible Study plans with his/her school teacher in advance. I assume all risks and hazards incidental to Bible Study participation *
Required
Parent Signature *
Date Signed *
MM
/
DD
/
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This program is entirely voluntary and not affiliated with School District #118.

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