Child Registration 2018-2019 KidzRock ~ WOW ~ JUMP56
SUNDAY KidzRock runs September 9th through May 19th from 9:30 am - 10:30 am .
The following Sundays we do not meet: Nov. 25th, Dec. 23rd, Dec. 30th, March 17th, March 24th and April 21st.
**3 year olds MUST TURN 3 BY September 15, 2018.

WEDNESDAY WOW and JUMP56 runs September 12th through November 14th and then January 9th through April 24. We take a break for Advent and then take spring break week off.

Questions or Concerns:

Please contact kidz@naz.org or call NAZ at (319) 266-7589.

Email address *
Parent/Guardian First and Last Name *
Your answer
Parent/Guardian Phone Number *
Your answer
Parent/Guardian Mailing Address *
Your answer
Zip Code *
Your answer
Secondary Parent/Guardian Email Address
Your answer
Secondary Parent/Guardian Phone Number
Your answer
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Gender? *
Required
Child's Mailing Address, if different from Parent/Guardian Address
Your answer
Medical Conditions and/or Behavioral Concerns (Including Allergies) *
If your child has no known medical conditions or behavioral concerns, please type none.
Your answer
Child's Grade *
Child's Current School *
Your answer
My child will be attending *
Do you have a "KidCheck" account? *
Required
What is the phone number associated with the KidCheck account? *
Your answer
Photo/Video Release: Photographic and Video Recording devices will be used at this event and the images captured could be used for publicity and/or historical purposes in a print or web-based media outlet. *
Required
Does Children's Ministry have permission to give your household information to the Nazareth Church Database? This will include receiving a few extra emails a year (for example, fall kick off, Christmas and Easter invites, plus the 4 quarterly newsletters). *
Additional Information:
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A copy of your responses will be emailed to the address you provided.
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