GOLD RUSH 2018 eRegistration
Event Timing: July 9-13, 9:15am-12:15pm (2018)
Event Address: Carol Baptist Church, 800 S. 6th St., Atchison KS 66002
Contact us at (913) 367-2334 or cbcatchison@gmail.com
Email address *
If multiple children are attending, please register each child individually on this form. Thank You!
Child's Name *
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Gender *
Required
Birthday *
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Last grade your child completed *
Address *
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City *
Your answer
ST
ZIP *
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Parent/Guardian *
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Parent contact phone *
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Please place my child with...
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Name of current Home Church (if any) and Pastor *
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Food allergies & dietary restrictions (please list) *
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Medical concerns (please list) *
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What days will your child likely attend? *
Required
A copy of your responses will be emailed to the address you provided.
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