MIX student registration 2018-19
Filling out this form registers your child (4 years of age through 12th grade) in the 2018-19 MIX year at Atascadero United Methodist Church. Schedule varies by age, please refer to the schedule at https://atascaderoumc.org/who-we-are/children-youth-ministries/mix-mid-week-student-ministry/ where you can also see the yearly schedule. Please fill out one form for each child you are registering for the MIX.

PAYMENT
The MIX calendar consists of four quarters, each includes at least four Wednesdays. The registration fee covers the cost of the meals, supplies and curriculum. The cost per child in a family per quarter is as follows:
1st child $35
2nd child $30
3rd child $25
4th child no additional charge
You may pay per quarter or annually: IF YOU PAY IN ADVANCE FOR THE YEAR, YOU RECEIVE A $5 DISCOUNT PER QUARTER. For example, if you paid in advance for the full year, you would pay $120 instead of $140. If only attending 3 quarters, you would pay $90 instead of $105. Payments may be made on Sunday (put in the offering basket with "The MIX" and your child's name in the memo, in the church office or online at https://bit.ly/2BdXXEj

Child's name *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's school *
Your answer
Will your child ride the AUSD school bus to Paloma Creek Park *
Home/mailing address *
Your answer
Child's T-shirt size *
Any food allergies? *
Your answer
Are there any medical conditions or concerns that the volunteers of the MIX need to be informed of? Please explain. *
Your answer
Name of Parent/guardian 1 *
Your answer
Home address of parent 1 if different than child's
Your answer
Parent 1 Cell Phone # *
Your answer
Email address for Parent 1 *
Your answer
Name of Parent/guardian 2
Your answer
Home address of parent 2 if different than child's
Your answer
Parent 2 Cell Phone #
Your answer
Parent 2 Email address
Your answer
What is the best way to contact you? *
Required
Is there anyone no allowed to pick up your children from The MIX? If so, please specify who. *
Your answer
Parent volunteering is encouraged, would you be able to volunteer at any of the MIX meetings? *
Which areas would you like to help with? *
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms