Wednesday Night Live Registration Form 23-24

Wednesdays, 6:30-7:30pm | See you at Wednesday Night Live!

Child's Name:

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Current Age/Grade:

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Please select one option.

FABC Kids Care (Infant - 2 Years Old) 3 Years Old (by 8/31/23) Pre-K Kinder 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade

Email:

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This address will receive a confirmation email

Is your child allergic to any foods or medicines? (Please list.) If so, will your child be bringing an Epi Pen to Wednesday Night Live?

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Please list all adults authorized to pick up your child from Wednesday Night Live:

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Please list another person to contact in the case of an emergency. Please include their name, cell phone number and relationship to you/your child. (Please note that we will try to contact you first in the case of an emergency.)

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To make this a better experience for your child, are there any special needs he/she has that we should plan to accomodate?

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Any child that participates in Wednesday Night Live may be photographed used in church communication, including social media posts.

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Please select one option.

I understand. I have a special situation that I will discuss with Laura.

Description

Wednesdays, 6:30-7:30pm

See you at Wednesday Night Live!

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