MYMARRIAGE FUNCARE FOR KIDZ - REGISTRATION FORM

9:00am - 6:00pm | Funcare for Kidz
Available Saturday, April 27, 2019
9:00am - 6:00pm
Ages 3 months- Grade 5
(Lunch not provided)

A FUN day is planned for children to enjoy an interactive bible lesson, music, games, arts and crafts, snacks, and a movie.

Please register early as SPACE IS LIMITED.

Child 1 (First & Last Name)

*

Age

*

Please select one option.

Birth - 2 yrs 2 (Potty Trained) - 5 yrs 6 - 11 yrs

Gender

*

Please select one option.

Male Female

Child Allergy/Health information

*

Child 2 (First & Last Name)

Age

Please select one option.

Birth - 2 yrs 2 (Potty Trained) - 5 yrs 6 - 11 yrs

Gender

Please select one option.

Male Female

Child Allergy/Health information

Child 3 (First & Last Name)

Age

Please select one option.

Birth - 2 yrs 2 (Potty Trained) - 5 yrs 6 - 11 yrs

Gender

Please select one option.

Male Female

Child Allergy/Health information

Parent Name

*

Email

*

This address will receive a confirmation email

Mobile Phone

*

Address

*

Emergency Contact Name

*

Emergency Contact Number

*

My child(ren) has(have) permission to attend and participate in the MyMarriage Conference Funcare for Kidz. In addition, I give permission to Daybreak Assembly's media team to photograph and/or film my child(ren) for promotion & publication purposes.

*

Please select all that apply.

I agree I do not agree

I understand that I need to provide lunch for my child(ren) in a plastic disposible bag or container with my child(ren)'s name clearly printed on it.

*

Please select all that apply.

Yes

Description

9:00am - 6:00pm

Funcare for Kidz
Available Saturday, April 27, 2019
9:00am - 6:00pm
Ages 3 months- Grade 5
(Lunch not provided)

A FUN day is planned for children to enjoy an interactive bible lesson, music, games, arts and crafts, snacks, and a movie.

Please register early as SPACE IS LIMITED.

Please Fix the Following

Close