Rockin' Wednesday Fall Registration
Rockin' Wednesdays at Rockbridge Church Meets Wednesday Nights from 6:00-7:30pm. It includes programming for children Nursery age through 5th Grade. Students will be served an optional meal from 6-6:30 and have games and activities and lessons from 6:30-7:30. Registration is required to participate in meals. A menu calendar will be sent out each month so you can RSVP for specific meals. Please include a good contact number and email to receive communication about Rockin' Wednesdays when you register.
Email address *
Parent/Guardian Name(s) first and last *
Your answer
Parent Contact Phone number (Primary emergency contact) *
Your answer
Secondary Parent/Guardian Contact Phone
Your answer
Number of children Registering for this household *
Required
Will you be Registering for meals? (how many) Food will be provided for Pre-k-5th grade students each week from 6-6:30pm. Meal schedules will be sent out each month to RSVP for specific meals. (Meals will be Peanut free, but Special Food allergy accommodations may not be available. If your child has severe food allergies, please bring food or feed them ahead of time.) *Please note- Nursery care will not include a meal, but they may bring peanut free food or snacks *
Required
To help support our mission of coming alongside families to disciple children, and to ensure enough adults present each week to provide a safe and effective program, we are requesting that an adult member each family serve* at least 1 week per semester. Please select at least 1 of the following weeks that your family can help serve (at least 1 parent) *if neither parent is Ministry safe cleared, please select a date at least two weeks out to allow time to complete Ministry Safe Background checks.
Child 1 Name (first and last) *
Your answer
Date of Birth *
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Grade range *
Child 2 Name
Your answer
Date of Birth (child 2)
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DD
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YYYY
Grade range (child 2)
Child 3 Name
Your answer
Date of Birth (child 3)
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DD
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YYYY
Grade range (child 3)
Child 4 Name
Your answer
Date of Birth (Child 4)
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DD
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YYYY
Grade range (Child 4)
Child 5 Name
Your answer
Date of Birth (Child 5)
MM
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DD
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YYYY
Grade range (Child 5)
Questions or comments you want to ask or let the Rockin' Wednesday Director know
Your answer
A copy of your responses will be emailed to the address you provided.
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