Quest for Christ Registration Form

Quest for Christ at Neil Armstong

2024-25 Student Registration Form
Calling all 3rd-5th grade students. Please invite your friends to join you Monday afternoons for faith and fun! Games! Snacks! Music! Bible message! Friends! Quest for Christ will meet Monday afternoons from 3:30 to 4:30 pm in the Neil Armstrong cafeteria. Fall session, Nov 4-Dec 16. Winter session: TBD. It's free to come so join us and invite a friend! Questions? Contact Barb Millage, (563) 940-3678, email barbaramillage23@gmail.com.
Student Name*

First NameLast Name
Birth Date

MonthDayYear
Gender*
Student's Grade*
Student's Teacher
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Any medical conditions, behavior concerns, or allergies we should know about? (Please write "none" if none)*
After each Quest meeting, my child will:

Be picked up from schoolWalk home from school
Parent/Guardian Name*

First NameLast Name
Parent E-mail*
Parent/Guardian Phone Number*

Area CodePhone Number
By providing your email address/phone, you are agreeing to receive email or text updates about Quest club activities, including announcements and cancellations. We will not share your contact information with others.
Emergency Contact Name (other than parent listed above)

First NameLast Name
Emergency Contact Phone Number

Area CodePhone Number
Would you like to purchase a neon orange Quest for Christ T-shirt to wear to club meetings? T-shirts are $10 - make checks out to "One Eighty" and send to a club meeting.

YesNo
T-shirt size requested

Youth MediumYouth LargeYouth X-LargeAdult SmallAdult MediumAdult LargeAdult X-Large
Please read carefully: By submitting this form, I give my permission for my student to attend Quest for Christ meetings and participate in related activities. I will not hold Quest for Christ or One Eighty responsible for any accidents or injuries that may happen during meetings or activities. I also give permission for my student to be photographed, videotaped or electronically imaged for ministry publicity purposes. The images will be the sole property of Quest for Christ and One Eighty.
After reading the above information,*

Yes, I agree
Please type your name if you agree with the statement above*

First NameLast Name
Quest for Christ meets in public schools under the provisions of the Equal Access Act and is given the same rights and restrictions as other before- or after-school clubs. Quest for Christ meeting at this school is not an endorsement by the school of the club’s content or beliefs.
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Quest for Christ at Neil Armstong