5-Day Club Registration Form

Please fill out a separate form for each child attending.

Click "submit" when finished.

Child's Information

Child's Name

Birthday

Allergies

Which 5-Day Club is your child planning to attend?

Please select one option.

Calvary Community Church (July 7th - 11th, 9am-12pm) Tangent Community Church (July 7th-11th, 1-3pm) Lacomb Bible Church (July 7th-11th, 6-8pm) Crowfoot Baptist Church (July 28th - August 1st, 9-11am)

Parent/Guardian Information

Parent/Guardian Name

Address

This address will receive a confirmation email

Phone

Work Phone

Emergency Contact

Name

Cell Phone

Additional Information

In additon to myself and the emergency contact, the following people are allowed to pick up my child:

Person 1 Name

Person 1 Cell Phone

Person 2 Name

Person 2 Cell Phone

My child may walk home after the club:

Please select one option.

Yes No

My child is allowed to be photographed:

Please select one option.

Yes No

Is there anything else we should know about your child?

Would your child like to receive our free, monthly Growing Stronger postcard?

Please select all that apply.

Yes No Already receive it

By submitting this form, you (the parent/guardian) agree that your child has permission to attend the 5-Day Club selected above. You must pick up your child each day after the club unless permission to walk home is marked on the registration form.

Description

Please fill out a separate form for each child attending.

Click "submit" when finished.

5-Day Club Registration Form

Description

Please Fix the Following