Quest for Christ Registration Form

Quest for Christ

Student Registration Form
You are invited to join us at one of the local elmentary schools listed below for a once-per-week meeting taking place either right before or right after school! This program is free, open to anyone attending school at the buildings listed (grade level dependent) and is sponsored by One Eighty. We will fill our time together with games, snacks, music, Bible message, small group and friends.

If you would like more information prior to signing up your child OR you would like to serve as a volunteer, please contact Cheryl Winger (Quest for Christ Supervisor for One Eighty) at 563-505-2040 or cheryl@oneeighty.org
Which school does your child attend?

Hoover Elementary in Bettendorf (starts 11-4-24, meets on Mondays 3:30p-4:30p)Paul Norton Elementary in Bettendorf (starting in Jan 2025- likely held on Weds from 2p-3p)Bridgeview Elementary in PV (starts 10-23-24, meets on Wednesdays from 7:30am-8:15am)Cody Elementary in PV (starts 10-15-24, meets on Tuesdays from 7:30am-8:15am)Forest Grove Elementary in PV (starts 10-11-24, meets on Fridays from 7:30am-8:15am)Pleasantview Elementary in PV (starts 10-10-24, meets on Thursdays from 7:30am-8:15am)Riverdale Heights Elementary in PV (starts 10-4-24, meets on Fridays from 7:30am-8:15am)Blue Grass Elementary in Blue Grass (starts 10-9-24, meets on Wednesday from 8am-8:45am)Hayes Elementary in Davenport (starts 10-17-24, meets on Thursdays from 2:55pm-4pm)Madison Elementary in Davenport (starts 10-17-24, meets on Thursdays from 2:55pm-4pm)Walcott Elementary in Walcott (starts 10-15-24, meets on Tuesdays from 4pm-5pm)Wilson Elementary School in Davenport (TBD, starting Jan 2025)I don't see the school my child attends- I want more info
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)*
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
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
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.
If the club I selected meets after school, what is the child's transportation plan:*

Picked up at the school by parent or guardianWalks home from schoolAttends an aftercare program at the school
Should be Empty: