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Wild About Jesus ~ Sunday Funday Registration Form - Sunday, October 10, from Noon to 3 p.m.
Kathy Peters - Family Ministries Coordinator ~ Cell: (315) 368-3391 ~ Email:
kpeters@bglighthouseumc.com
Please feel free to call or email me any time with your questions.
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Student's Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Grade in School
Your answer
Allergies/Special Needs
Your answer
Student's Name (If more than one student)
Your answer
Date of Birth
MM
/
DD
/
YYYY
Grade in School
Your answer
Allergies/Special Needs
Your answer
Student's Name (If more than two students)
Your answer
Date of Birth
MM
/
DD
/
YYYY
Grade in School
Your answer
Allergies/Special Needs
Your answer
Parent/Guardian:
Your answer
Home Address (Please include address, city, state and ZIP code):
Your answer
Home Phone:
Your answer
Cell Phone:
Your answer
Email
Your answer
Preferred Contact Method:
Phone
Email
Please check the box below, if applicable:
By checking this box, I give my permission to have my child(ren) photographed during church activities for use in social media, on the website, and on printed promotional materials for the church.
I would like to help out with the "Wild About Jesus" Sunday Funday on October 10 from noon to 3 PM:
Lunch/Refreshments
Registration
Crafts
Games
Parent/Guardian Electronic Signature (Print your name below):
Your answer
Date:
MM
/
DD
/
YYYY
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