Wednesday Night Live Registration Form 25-26

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

Email:

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This address will receive a confirmation email

Parent Name:

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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 8/31/25) Pre-K Kinder 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade

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 Ashley.

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Wednesdays, 6:30-7:30pm

See you at Wednesday Night Live!

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