PRE- NYE Student Hangout RSVP- All Grades
Who: All Grades ( 6 - 12)

What: Join us for our last hangout of the year as we prepare to ring in the New Year with Friends in a Fun and Save environment. It will be a night of Fun, Friends, Food, and Faith discussions.

When: Friday, DEC 27, 2019 | 7pm - 9pm

Where: Montclair Campus | Q-Chapel

Cost: $5 per person

Got Questions?
Email: | Text or Call 201.286.1445

Please Note: All Events Are Subject to Change
Email address *
Are You Attending? *
General Information
Name of Student(s) *
Your answer
Campus *
Legal Guardian or Parent Name *
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Grade Level or Role *
Emergency Information
Emergency Contact Name & Phone Number *
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Family Doctor Name & Phone Number Insurance Company Name & Policy#
Your answer
Family Dentist Name & Phone Number | Insurance Company Name & Policy#
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Allergies or Current Medications. Any Other Medical Information You Want Us to Know.
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Hold Harmless Agreement
I agree to hereby release Christ Church and the directors thereof from any responsibility and liability for injury or loss occurring while participating in any activities at the church, or under it’s supervision. *
Medical Release
I hereby authorize and consent to any x-ray, examination, anesthesia, medical, surgical, or dental diagnosis or treatment and hospital care to be rendered under the general or specific supervision and on the advise of any physician or dentist licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. *
Permission to Reproduce Images
I hereby authorize Christ Church to use images of my child on Facebook, the web, or advertising. *
Thank you for confirming! A reminder text or email will be sent to you confirming your attendance! Please text us at 201-286-1445 if you’re unable to attend.
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