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WOW 2023-24 registration
Event Timing: Wednesday's during the school year from 5:30-7:00pm
Event Address: 1100 N. Calhoun Street, West Liberty, IA 52776
Contact us at (319) 627-2989 or
firstchurchunited@gmail.com
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Email
*
Your email
Name of child
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Your answer
Primary Parent contact's name
*
Your answer
Primary contact's email address
*
Your answer
Additional adult authorized to pick up your child
Your answer
Secondary email address
Your answer
Secondary phone number
Your answer
Address
Your answer
Child's date of birth
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DD
/
YYYY
Any Allergies?
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None
Other:
Child's grade in school fall of 2023
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Toddler
Preschool
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
Any special needs or concerns you would like to share regarding your child?
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I give my permission for my child to have his/her picture taken for items such as our church website, brochures, Facebook, the West Liberty Index.
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