VBA June 28, 29 & 30
5:30-800
Student name
First Name
Last Name
Student grade completed this year
Guardian email
example@example.com
Guardian emergency phone number
Please enter a valid phone number.
Guardian name
First Name
Last Name
I give my child permission to attend the above event. If we can not get in contact with the above guardian, should an accident or injury occur, I grant East Immanuel staff permission to take my child to the nearest hospital and/or seek medical attention. I will not hold East Immanuel Church liable for any injury or accident that may occur while attending this event.
Submit
Should be Empty: