Messy Church Registration Form - Adults
Sunday 12th December 2021 11:40am - 1:40pm @ Killead Presbyterian Church (Closing date for registration - Friday 10th December 2021)
Name of Adult attending
First Name
Middle Name
Last Name
Contact Number
Medical and/or Dietary Info
Name of Adult Attending
First Name
Middle Name
Last Name
Contact Number
Medical and/or Dietary Info
Name of Adult attending
First Name
Middle Name
Last Name
Contact Number
Medical and/or Dietary Info
Name of Adult attending
First Name
Middle Name
Last Name
Contact Number
Medical and/or Dietary Info
Name of Adult attending
First Name
Middle Name
Last Name
Medical and/or Dietary Info
Contact Number
Additional Information (if relevant)
I give my permission for my photograph (and that of the others I wish to register, if applicable) to be taken and used on the church's website and Facebook page.
Please Select
Yes
No
Submit Application
Clear Fields
Should be Empty: