Feed My Starving Children and Pine Haven
We will be going to Feed My Starving Children in the morning enjoying a day together at Pine Haven Farms in Wyoming. On October 17th, we will leave the church at 8 am and return around 3 pm. Limited to the first 18 kids to register. Parent volunteers to drive are needed as well. Cost $20, covers the fee for Pine Haven. Please pack a bag lunch or bring money for lunch.
Child's Name
*
First Name
Last Name
Child's Grade
*
Preschooler Enter 10 - Kinder enter 0
Child's Age
*
Home Church:
Allergies/Medical Conditions
*
Parent Name
*
First Name
Last Name
Address
*
Street Address
City/State/Zip Code
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Emergency Contact (if parent is not available)
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
I hereby give permission for this child to participate in all activities and release Our Redeemer Lutheran Church and its staff and volunteers from any liability.
*
Yes
No
I give permission to take pictures of my child, which may be included in church promotions and publicity.
*
Yes
No
Would you be willing to chaperone and drive for this event?
Signature
*
Submit
Should be Empty: