Adventure Week Registration
Event Timing: July 15th to 19th
Event Address: 15oo East Walnut Chatham Il 62629
Contact us at (217) 483-2471 or jerryaweber@comcast.net
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First Name *
Last Name *
Preferred Name
Birth Date *
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DD
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Grade Starting in Fall 2024 *
Parent Full Name *
Address *
Phone Number *
Email *
Church Home *
Do you want more information about Chatham Baptist Church? *
If yes, what is the best way to contact you?
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Please share important medical and/or food allergy concerns so that Chatham Baptist Church can ensure a fun and safe time for your child.
Emergency Contact Name and Number #1 *
Emergency Contact Name and Number #2 *
May your child be captured by photography and/or videography for the purposes of promoting Adventure Week in various outlets as deemed appropriate by Chatham Baptist Church? *
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