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OLYMPIANS REGISTRATION FORM
EMMANUEL BIBLE CHURCH
Olympian Club Member Registration/Permission Form
2019-2020
Please be sure to complete all sections and click submit when done. Thank you!
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Address
Street: *
Your answer
Town: *
Your answer
Postal Code: *
Your answer
PHONE (Home) (Enter N/A if not applicable) *
Your answer
PHONE (Cell) (Enter N/A if not applicable) *
Your answer
PHONE (Work)
Your answer
Email (Enter N/A if not applicable) *
Your answer
QUIET TIME ORDERS
Quiet Time daily devotional book
Cost: All levels $23.00
Family Rate (3 or more children at Olympians) - $55.00
Carry Bag (Red, Blue or Green): $5
Please order:
Starters (JK & SK)
Challengers (Grades 1 & 2)
Conquerors (Grades 3 & 4)
Champions (Grades 5 & 6)
Carry Bag (Red)
Carry Bag (Blue)
Carry Bag (Green)
child 1
child 2
child 3
child 4
Child #1 First name: *
Your answer
Child #1 Last name: *
Your answer
AGE *
Birth Date (DD/MM/YY) *
Your answer
Grade (starting Sept. 2019) *
Special Needs (Allergies, medical concerns or any other needs) (Enter N/A if not applicable) *
Your answer
ADD ANOTHER CHILD?
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