Union Baptist Church Centershot Class Wednesday

Union Baptist Church Centershot Class

Wed 4:30-5:30 PM
This form is for the Wednesday 4:30 to 5:30 PM class

Please fill out the form below to register your child for the Centershot archery class. Class starts on October 15th. Projected class dates are October 15, October 22, November 5, November 12, November 19, December 3, December 10, and December 17.
Child's Name*

First NameLast Name
Child's Date of Birth*

MonthDayYear
Date
Gender

MaleFemale
Current school grade
School name/Homeschool/Co-op
Has your child participated in the National Archery in Schools Program (NASP)?*

Currently competingCompeted in pastNever competed
What is your child’s dominant eye? If unsure, what hand do they use to write?*

Right eye dominantLeft eye dominant
Does your child have their own Genesis bow?*

YesNo
Note:

Please provide your current email and phone number. These will be the primary sources for us to contact you regarding schedule changes, cancellations, etc.

Providing your current mailing address allows us to send your child such things as birthday cards.
Home Church (if you have one)
Parent/Guardian Name*

First NameLast Name
Parent or Guardian Phone Number*
Please enter a valid phone number.
Parent or Guardian Email Address*
example@example.com
Parent or Guardian Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact (if we are unable to reach you immediately)*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.
Emergency Contact Relationship*
Consent to Participate*

I agree to the safety rules and guidelines of Union Baptist Church.I consent to having my child's photographs taken during activities for promotional purposes.
Additional Information

Please provide any additional information, medical conditions, allergies we should be aware of.
Additional Notes or Medical Conditions
Should be Empty:

Union Baptist Church Centershot Class

This form is for the Wednesday 4:30 to 5:30 PM class

Note:

Additional Information