Easter Party Club Sign-up
Student Info
Student Name
*
First Name
Last Name
Age (5-12)
*
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Grade in School (K-6)
*
School Attending
*
Phone Number
*
Please enter a valid phone number.
Parent Email
*
example@example.com
Address
*
Mailing Address
Mailing Address Line 2
City
State / Province
Postal / Zip Code
Party Club Your Child Will Be Attending
*
Monroe Easter Party Club April 12th 1-3pm (Monroe Christian Church, 180 S 6th Street Monroe, OR 97456)
Philomath Easter Party Club April 12th 1-3pm (Philomath Middle School 2021 Chapel Dr, Philomath, OR 97370)
The Gathering Easter Party Club April 19th 9-11am (5050 NE Elliott Circle, Corvallis OR 97330)
Alsea Easter Party Club April 19th 1-3pm (Alsea Christian Fellowship, 18080 Alsea Hwy, Alsea, OR 97324)
Who will be doing pick-up/drop-off for your child?
*
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 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 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. Names will be changed for privacy.”
Guardian's Signature
*
Any Additional Notes/Food Allergies
Submit
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