WOW Registration form - First Church United, West Liberty.

WOW Registration form for school year 2021-2022

PLEASE COMPLETE A SEPARATE FORM FOR EACH CHILD REGISTERED. Children must be potty trained, PreK - 6th grade. WOW is held each Wednesday from 5:30-7:30 p.m. during the school year. A light dinner is provided along with bible study, crafts, games and fun.
Child's Name *

First Name Last Name
Primary Parent Contact's Name *

First Name Last Name
Primary Contact's Email Address *
Primary Contact Phone Number *

Area Code Phone Number
Additional Adult Authorized to Pick Up your Child

First Name Last Name
Secondary Email Address
Secondary Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Child's Date of Birth *

Month Day Year
Any Allergies?
Child's Grade in School fall 2021 *
How would you like to volunteer?
Any special needs or concerns you would like to share regarding your child?
I give permission for my child to have his/her picture taken for items such as our church website, brochures, Facebook, the West Liberty Index. *
Please type yes or no
Should be Empty:

WOW Registration form for school year 2021-2022