Mascoutah Kids For Christ Registration Form

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Who: Mascoutah Elementary Students Kindergarten through 5th Grade

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

When: Thursdays, February 22nd - March 21st dismissal-5:00 pm.

Why: We teach the truth & hope found in the Bible. This basic foundation of faith will help children their entire lives.

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

Please plan to join us for our closing program Thursday, March 21st at 4:45pm.

Mascoutah Elementary 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-5pm) *

Will your child go to Extended Care after Kids For Christ *

Yes

Required

Allergies/Special Concerns *

Yes

Required

If yes, please explain

Does your child have a bible at home?

Yes

Photo Release

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.

I would like to:

Volunteer

Donate Snacks

Clear selection

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. *

I agree to the statement above.

Required

Parent Signature *

Date Signed *

YYYY

This program is entirely voluntary and not affiliated with School District #19.

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