Proclamation Children's Music Registration 2017-2018
Proclamation Presbyterian Church - Age 4 through 8th Grade

Please contact Kelly@proclamation.org with any questions.

Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Gender
Child's Age on 9/17/2017 *
Your answer
Child's Birthday *
MM
/
DD
/
YYYY
Child's Grade Level *
Child's School *
Your answer
Child's Height (approximate) *
Your answer
Child's allergies, if any:
Your answer
Parent 1 - Full Name *
Your answer
Parent 1 - Email address (best/checked regularly) *
Your answer
Parent 1 - Cell number *
Your answer
Parent 1 - Address *
Your answer
I would like to receive occasional text message reminders
Parent 2 - Full Name
Your answer
Parent 2 - Email
Your answer
Parent 2 - Cell number
Your answer
Parent 2 - Address (If different)
Your answer
Parents are interested in helping with:
Child's Church Home (if any)
Number of family members anticipated for Wed. church dinner reservation, when attending
Your answer
Additional comments/info/questions
Your answer
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