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!
Email address *
Participant's Name (First & Last) *
Your answer
Address (Street, City, State, Zip) *
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Last Grade Completed (Note: children will be grouped by grade) *
Required
T-Shirt: $5 (Must be registered by May 26 to receive a shirt!)
Allergies/ Food Allergies/ Emergency Info (Children Only) *
Your answer
Insurance Company/ Policy #/ Group # *
Your answer
Parents' or Guardians' Name and Phone Numbers (Children Only) *
Your answer
Additional Emergency Contact Names and Numbers
Your answer
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.)
Your answer
Additional Notes/ Concerns for Child
Your answer
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 *
Required
I give permission for my child to participate in Family Faith Fest and all activities included in the event. *
Signature *
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service