Summer D.I.P. Registration
Take a D.I.P. into summer with these fun children's events with Mt. Zion UCC. These programs are open to all Mt. Zion kids, ages 5 through 6th grade. Children aged 5 should be accompanied by a caregiver for week 1 (June 22).
Summer D.I.P. Registration
Names and Ages of Children Being Registered *
Your answer
Email *
Your answer
Parent Name(s) *
Your answer
Cell Phone Number *
Your answer
Which Summer D.I.P. events will your child attend? *
Required
We are in need of chaperones and helpers for these awesome events. Please indicate below which dates you are available to help (check all that apply).
In the event of an emergency, who may be contacted if you cannot be reached? (name and phone number) *
Your answer
Are there any special circumstances (allergies, etc.) that we should be aware of so that we can best serve your child?
Your answer
If a hospital is necessary, I grant permission for my child to be transported to the nearest hospital, and I give permission for the hospital to arrange such emergency treatment as may be needed. I will assume responsibility for fees incurred by such an emergency. *
I, the undersigned, do hereby grant or deny permission to Mt. Zion United Church of Christ in York, PA to use the image of myself or my child as marked by selection below. Such use includes the display, distribution, publication, transmission, or otherwise use of photographs, images and/or video taken of myself or my child for use in materials that include, but may not be limited to, printed materials such as brochures and newsletters, videos, and digital images such as those on the Mt. Zion website and facebook page. *
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