Music and Missions Registration Form

Please provide the following contact information:

Child's Name
Male or Female	- Male Female
Birth date (M/D/Y)
Age or Grade	Please Choose 3 Years Old 4 Years Old 5 Years Old/ Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade
T-shirt size	Choose Size YS YM YL AS AM AL AXL
School
Address
City
Zip
Your Name
Home Phone
Work Phone
Cell Phone
Parent's E-mail

Please list detailed information on where parent can be reached during

Music and Missions (5:30-7:00):

 

Please list any food allergies or other helpful information:

 

Church Member	select one Yes No
Name of Church

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Will you be willing to help your child’s music or missions group for parties,

special projects, chaperoning, or getting ready for programs if needed?

Yes, I would like information on helping as a teacher or assistant

Yes, on an as needed basis

NO

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Please remember, that we need to have a separate registration for each child who will participate.

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