• for Age 3 - Grade 5

    Wednesday Nights
    6:30 - 8:00pm
    Sept 29, 2021 - May 11, 2022

     

    Please fill out a separate registration form for each family.
    This will enable us to have the correct parent/guardian & contact info for each child. Thank you!

  •  /  /
    Pick a Date
  • General Information


    • Child #1 Section  
    • Child #1

    •  /  / Pick a Date

    • Child #2 Section  
    • Child #2

    •  /  / Pick a Date

    • Child #3 Section  
    • Child #3

    •  /  / Pick a Date

    • Child #4 Section  
    • Child #4

    •  /  / Pick a Date

    • Child #5 Section  
    • Child #5

    •  /  / Pick a Date

    • Child #6 Section  
    • Child #6

    •  /  / Pick a Date
    • Parent/Guardian Section  
    • Parent/Guardian Info:

    • Medical/Allergy/Emergency Contact Information

    • Dismissal: Who can pick up your child(ren)?

    • Church Affiliation

    • Should be Empty: