Christmas Party Club Sign-up

Christmas Party Club Sign-up
Student Info
Student Name*

First Name Last Name
Age*
Child's Date of Birth*

MonthDay Year
Date
Grade in School*
School Attending*
Phone Number*
Please enter a valid phone number.
Parent Email*
example@example.com
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Party Club Your Child Will be Attending*

Santiam Christian School - December 9th, 3:05-4:30Philomath Community Church Gym - December 20th, 3-5 pmA Christmas Party Club at one of our eight Good News Clubs - Week of December 12th-16th - See GNC page for locations and when.
Guardian's Full Name*
"By signing this form, I, the parent (or guardian), do hereby give permission for my child to attend and participate in a Christmas Party Club. I release Child Evangelism Fellowship and the facilities used from liability for any injuries or sickness incurred as a result of my child’s participation in a Christmas Party Club. I hereby assign and grant to Child Evangelism Fellowship full use of all photographs of the above named child, without reservation or limitation, including use of photographs for promotional purposes.”
Guardian's Signature*
Any Additional Notes/Food Allergies
Should be Empty:

Student Info