Club 56 Registration for 2018-19
Name (First and Last) *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Grade level as of September 2018 *
Names and address/es of parents
Your answer
Preferred Phone Number *
Your answer
Parent's email addresses
Your answer
Allergies
Your answer
Emergency contact (name and phone number)
Your answer
What is the child's relationship to the emergency contact?
Your answer
Initial here to provide permission for Zion to use any pictures taken of your child in the church newsletter, website or facebook pages
Your answer
Is there any additional information you would like the staff at Zion to be made aware of?
Your answer
Parent Volunteer Form
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