Flash: ON   September 8, 2010 
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Wednesday Night Live Kids

   
Wednesday Night Live Kids' Registration
August 19 - May 12
6:30 - 7:30 P.M.
   Please complete and submit one form for each child you are enrolling
   Child's Name
   
   School
   
   Grade
   
   Birthday
   
   Food Allergies
   
   Special Needs
   
   Parent(s)/Guardian(s) Name
   
   Address
   
   City, State Zip Code
   
   Home Phone
   
   Cell Phone
   
   Office Phone
   
   Email Address
   
   Please select one of the following:
   
   

By submitting this form, you are agreeing to allow your child's photograph to be used in church publications.


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