New Friends - Jesus Cares Registration
Welcome! We are excited for you to be involved in our Jesus Cares Ministries program. Please provide the following information so we can ensure our program meets your needs. Our one day Vacation Bible School event will take place on Saturday, August 10th, from 1:30-3PM. The event is designed for kids with disabilities and their families. A parent or adult is required to attend the session. Siblings are welcome to attend as well. Please fill out an individual registration for each child. (If no medical issues or needs are present, write N/A)
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Email *
Child's name (First and Last) *
Birthdate (--/--/--)  *
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DD
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Address, City, State, Zip *
Allergies/ Dietary Restrictions *
What medical issues does your child have and how we should prepare for them? *
Name of Parent(s) who will attend the event with the child *
Parent/Emergency Contact #1 Phone Number *
Parent/ Emergency Contact #2 *
Parent/ Emergency Contact #2 Phone Number  *
How many total people will be attending from your family?  *
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