Child Name *

First Name

Last Name

Grade Entering in Fall 2024 *

Pre-K (potty trained)

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

Parent/Guardian Name *

First Name

Last Name

Phone *

(###)

###

####

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####

T-Shirt Size *

Youth XS

Youth S

Youth M

Youth L

Adult S

Adult M

Adult L

Photo Release *

Do you agree to allow photos of your child to be used in church presentation or church promotional materials?

Yes

No