Registration Form
Lake Ozark Christian Church is offering a free after-school program for children, grades Kindergarten through 5th grade (Heritage and Upper Elementary Schools), on Wednesdays from 3:30pm to 5:30pm. The program begins Wednesday, September 9. We will transport the children from school to the church building. We will provide a snack, games and activities, and a brief lesson. A parent or guardian will need to pick up their children by 5:30pm. There is no cost to attend this program.
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Email *
Name of Parent or Guardian
 *
Phone *
Name of Parent or Guardian
Phone
Email
Emergency Contact in case parent/guardian cannot be reached
 *
Phone *
Name of Child
Birthdate
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DD
/
YYYY
Grade
Does this child require a booster seat?
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Name of Child
Birthdate
MM
/
DD
/
YYYY
Grade
Does this child require a booster seat?
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Other Children, Grades, and Birthdates
Any food allergies or health concerns?
Permission *
Required
Permission *
Required
I understand that if any improper behavior occurs with my children who is attending the youth group, I may be called to pick up my children. I further understand that any improper behavior may exclude my children from attending future meetings. *
Required
I give permission for my children’s picture(s) and or work to be posted in the newspaper, the church web site and social media, and other forms of communication. *
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