Christ Church: Home: Kids' Quest 2011-2012 Participant Registration

Christ Church Episcopal

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Christ Church Episcopal

5000 Pouncey Tract Road

Glen Allen, VA 23059

804-364-0394

804-364-0396 (fax)

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Kids' Quest 2011-2012 Participant Registration

Please complete all applicable information. Families with multiple children in Kids' Quest need only complete the phone number, email address, and address information for the first child registered. We look forward to your child's participation in Kids' Quest!

* Required

Errors

Child's First Name *

Child's Last Name *

Birthdate: *

Attends (check all that apply)

Saturday Night

Sunday Morning 8:50

Sunday Morning 10:35

Parent's Name(s):

Phone Number:

Email Address:

Child's Address:

Allergies/Special Needs:

Additional People Allowed to Pick Up Your Child:

I am interested in helping lead Kids' Quest, Children's Chapel, or other Children's Ministry Events

I give Christ Church permission to take and use pictures of my child in church publications (including but not limited to website and printed materials). *

Yes

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