Caravan 2019-2020
Caravan is a Christian scouting program for children age 3 - 5th grade. We meet on Wednesday nights during the school year from 6:15pm - 7:30pm.
Email address *
Name of Child *
Your answer
Birth Date *
MM
/
DD
/
YYYY
Grade 2019-2020 *
Does your child have an illness, allergy, or physical or mental challenge that we should be aware of? *
If yes, please specify what action should be taken and when.
Your answer
Do we have permission to treat your child in case of an emergency? This includes, but is not limited to: first aid, administering an epi pen, giving CPR, and clearing an airway. *
Name & phone number of Parent/Guardian (primary contact) *
Your answer
Name & phone number of Parent/Guardian (secondary contact) *
Your answer
Who, other than the adults listed above, is authorized to pick up your child from Caravan. (Must be 18+) *
Your answer
Kids love cards! Please provide your address so we can send a card to your child if he/she misses a week and for his/her birthday.
Your answer
How would you like to be contacted should we need to cancel Caravan due to bad weather? *
Required
Check yes if you agree to the following: I, the parent or legal guardian of the child named above, agree to not hold South Portland Church of the Nazarene, it's employees or volunteers, liable for any accident, including injury, that might happen while said child is at Caravan, including the time my child is on the grounds before and after the program. *
I'm interested in volunteering. Please contact me. (Volunteers working directly with children must attend the church regularly for at least 6 months and undergo a background check.)
I have children in middle school. Please contact me about "Kindle," the faith building program for students in 5th-8th grade. (Meets the same time as Caravan.)
I'm interested in attending a small group during Caravan. Please send me a list of what will be offered.
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service