ROAR Registration Form
August 5-9, 2019
Wetzel Road Church of Christ
Contact us at (315) 652-3195
Child's Name *
Your answer
Child's Gender *
Child's Age *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Last School Grade Completed *
Your answer
Parent's Name(s) *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
ZIP *
Your answer
Home Telephone
Your answer
Parent's Cell Phone *
Your answer
Parent's Email *
Your answer
Home Church
Your answer
Allergies or other medical conditions (If none, please designate so) *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
Relationship to Child *
Your answer
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