FCC Date Night Childcare Questionnaire
Child's Name *
Child's Age *
Parent's Name *
Emergency Contact Number *
Address *
Are You Currently Affiliated With A Church? *
Allergies *
Waiver Agreement: I hereby release and absolve First Christian Church of Ramseur from any claims of damage to persons or property that occur during childcare. By signing below, I agree to these terms and conditions. Please sign by typing your full name below if you agree. *
If You Have Any Questions, Please Type It Here & We Will Respond As Quickly As Possible.
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