First United Methodist Church 2022-2023 JAM Registration Form

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JAM is for all students Pre-K through 6th grade. There is no fee for this program.

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Student Name *

Gender *

Female

Male

Grade: *

School *

Parent/Caregiver Name(s): *

Address *

Email Address *

Home Phone *

Cell Phone *

Emergency Contact (Name and Number) *

Parent's Church Affiliation

I would like to assist in the JAM Program by:

I need assistance with transportation *

Yes

My Child has permission to ride on church provided transportation *

Yes

I give permission for my child to have their picture taken for occasional church publications. *

Yes

The JAM program personnel are authorized to take my child to the hospital for emergency care in the case of a medical emergency. *

Yes

Allergies or other Medical Conditions: *

Those persons authorized to pick up my child(ren) after JAM are: *

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