Kids Fun Night Registration Form 2018-2019
*Washington Church sponsored event held at Grove Patterson Academy

*If you have already registered your child for the 2018-2019 school year, you do not need to register him/her again for each Fun Night, unless you are updating information.

Child First Name *
Your answer
Child Last Name *
Your answer
Grade *
Parent or Guardian Name *
Your answer
Contact Email *
Your answer
Contact Phone *
Your answer
Contact Address *
Your answer
Additional / Secondary / Emergency Contact *
Your answer
Additional / Secondary / Emergency Contact Phone *
Your answer
Any Known Allergies
Your answer
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