SCREAM Registration for Sep 15, 2024, 3-5pm
Thanks for registering your 3rd, 4th, and 5th graders for SCREAM! 
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Child's First Name
Child's Last Name
Child's birthdate:  Month, Day *
Child's year of birth *
Child's school grade *
Parent email address *
Street Address
City, State, Zip
Parent Full Name *
Parent Cell Number *
Emergency Contact Name other than parent
Emergency phone other than parent *
Dietary restrictions
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More information we should know to better care for your child?
As the parent or legal guardian of this child, do you agree to hold SCREAM Ministries and Nacoochee Methodist Church harmless in case of injury to your child?  Do you also agree that in case of emergency and we cannot contact you in a timely way, your child may be transported  to  a medical facility and needed aid may be rendered in your absence?  In the unlikely event a health emergency, do you agree that you are responsible for any cost of medical treatment? *
As the parent or legal guardian of this child, do you consent to the use of video, photographs, audiotapes, or any media in which your child may appear that these materials may be used by SCREAM Ministries and or Nacoochee Methodist Church to further the Christian Gospel? (child's name will never be used) *
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