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Parkside's Next Steps Class
August 7-September 4. You may do one registration for the Family
Next Steps Class
Child's First Name *
Your answer
Last Name *
Your answer
Home Address *
Your answer
Zip Code *
Your answer
City *
Your answer
Home Phone
(XXX) XXX-XXXX
Your answer
Parent's Cell Phone *
(XXX) XXX-XXXX
Your answer
Parent's Email Address *
Your answer
Parents Names *
Your answer
Parent(s) Work Phone
Your answer
Emergency Contact Information If Different than Parents Cell given above
Please provide name & number
Your answer
Allergies or Medical Conditions we should be aware of
Your answer
Number of Family Members Attending Dinner *
How Many will be attending the Class *
Do you grant permission for Parkside Church of the Nazarene to use pictures of your child on its website and social media for informational or promotional purposes. *
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