Guest Registration Form
What:
Shine Like Stars

When:
March 16, 2024
Doors open at 6:00pm

Where:
First Church of Christ
1310 SW 7 St.
Atlantic, IA 50022

Questions:
mbrandt@griswoldschools.org
1.515.971.6270
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Guest Name (First and Last): *
Guest Age (as of 04/01/2023): *
Address: *
Guest/Facility Email: *
Name of Date or Helper (if applicable)  *
Primary Contact (Name and Phone): *
Health Concerns: *
Special Communication Needs: *
Required
Sensory Issues/Concerns (strobe lights, camera flashes, loud noises, etc.): *
Required
Allergies (please check all that apply): *
Required
Transportation needed?
Is there anything we can be praying about for you?
Consent questions...
Guest wishes to allow pictures of themselves to be posted on social media, see below...
Consent to post pictures on First Church of Christ Facebook page? *
Parent/Caretaker Information
Parent/Caretaker (Name, Phone and Email): *
Care Provider Information (If applicable)
Care Provider (Agency, Phone and Email) *
Agency Chaperone (if applicable):
Additional Notes
Shine Like Stars 2024
What:
Shine Like Stars

When:
March 16, 2024
Doors open at 6:00pm

Where:
First Church of Christ
1310 SW 7 St.
Atlantic, IA 50022

Questions:
mbrandt@griswoldschools.org
1.515.971.6270
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