Roots Registration Form
5-8th grade students
Email *
Parent's Email Address *
Student Information
Student's Name *
Date of Birth *
Male or Female *
Grade *
Allergies *
Student will be picked up by: *
Parent/ Guardian Information
Name(s) *
Address *
Phone Number *
Do you text? *
In case of an accident, I give my permission for transportation to the hospital, and for any emergency treatment to be administered to my child. What hospital do you prefer? *
Occasionally photos may be taken of youth in which they may be used within the church, the church's website, church's Facebook, etc of the Tremont United Methodist Church. *
A copy of your responses will be emailed to the address you provided.
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