Maker Fun Factory Drop-in Afternoons ($5 a day or $20 for the Week)

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Child's Name

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Grade

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Please select one option.

Junior Kindergarten Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6

Birthdate

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Days attending (Approximately)

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Monday Tuesday Wednesday Thursday Friday All Week

Parent's Name

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Email

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Phone

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Address

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Allergies

Medical Information

Emergency Contact

*

Relation to Emergency Contact

*

Emergency Contact Phone Number

*

Other Information

Who can pick up your child at the end of the day?

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What church do you attend?

Is there a friend your child would like to be with?

Is there any other information we should know about your child?

Authorization

I authorize Temple Baptist Church to take pictures of my child which may be used in presentations and publications for church use.

*

Please select all that apply.

Yes No

I give you permission to contact me about future events.

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Please select all that apply.

Yes No

I understand that precautions are taken for the safety of my child, but in the event of accident or sickness, Temple Baptist Church, it's staff, and volunteers are hereby released from any liability.

Description

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