SummerFest Registration Form
Email address *
Child's Full Name *
Child's Date of Birth *
MM
/
DD
/
YYYY
Address *
Name of Child's Parent/Guardian *
Home Phone Number of Parent/Guardian *
Mobile Number of Parent/Guardian
Second Contacts Name *
Second Contacts Relationship to Child *
Second Contacts Phone Number *
Dietary Requirements *
Medical Conditions Relevant to Child *
Can Photos/Videos of your child be taken? *
Can Photos/Videos of your child be used for church purposes? *
I hereby confirm all details above are correct *
Required
Form filled in by *
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