Union Baptist Church Centershot Class Wednesday

Union Baptist Church Centershot Class

Wed 4:00-5:30 PM
This form is for the Wednesday 4:00 to 5:30 PM class

Please fill out the form below to register your child for the Centershot archery class. Class enrollment is for 6 weeks.
Child's Name

First NameLast Name
Child's Date of Birth

MonthDayYear
Date
Gender
Current school grade
School name/Homeschool/Co-op
Has your child participated in the National Archery in Schools Program (NASP)?
What is your child’s dominant eye? If unsure, what hand do they use to write?
Does your child have their own Genesis bow?
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.Format: (000) 000-0000.
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.Format: (000) 000-0000.
Emergency Contact Relationship
Consent to Participate
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 4:00 to 5:30 PM class

Note:

Additional Information