Family Faith Fest: Home Away From Home
June 7-8: Friday (5:00 P.M. - 7:00 P.M.) & Saturday (10:00 A.M.- 5:00 P.M.)
To register and receive a shirt must be done by May 26!
Late registrations with no guaranteed shirt must be done by June 2!
Participant's Name (First & Last)
Address (Street, City, State, Zip)
Date of Birth
Last Grade Completed (Note: children will be grouped by grade)
0-3 (Nursery Age)
Pre-School (4-Pre K)
T-Shirt: $5 (Must be registered by May 26 to receive a shirt!)
Allergies/ Food Allergies/ Emergency Info (Children Only)
Insurance Company/ Policy #/ Group #
Parents' or Guardians' Name and Phone Numbers (Children Only)
Additional Emergency Contact Names and Numbers
In addition to listed guardians, these people may sign my child out. (Children Only) (Note: Children will not be released to anyone who is not listed on this form.)
Additional Notes/ Concerns for Child
I give Clarksville CPC permission to use any images containing me or my child for any advertising or promotional materials
I acknowledge that it is my responsibility to pick up my child if they are sent home for any disrespectful, harmful, or otherwise deemed unacceptable behavior
I give permission for my child to participate in Family Faith Fest and all activities included in the event.
A copy of your responses will be emailed to the address you provided.
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