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Make A Difference Week Registration
Service Projects for Kids - June 27- July 1, 2022
Cost $30 per child, Free for high school volunteers
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Email
*
Your email
Parent/Guardian Name (First and Last)
*
Your answer
Address
*
Your answer
Phone Number
*
Your answer
Emergency contact if the above parent/guardian cannot be reached (Name and Phone Number)
*
Your answer
I give my child/children permission to participate in Make a Difference Week, July 26-30, 2021.
*
Yes
No
I give permission for my child's/children's photo (without his/her name) to be shown on Central Congregational Church of Chelmsford's bulletin boards, Facebook page and website.
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Yes
No
How many children are you registering on this form?
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