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Pastor Wayne’s Farewell Luncheon - June 9

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YOUTH THEATRE CAMP REGISTRATION

August 5-9. 9am - 12noon

Performance 8/9 at 12noon

Suggested Donation $300

ages 5 and up

Child's Name

First Name

Last Name

Child's Age

Child's Birthdate

MM

DD

YYYY

Grade

Please indicate child's grade level and school.

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Home Phone

Note: Please only use numbers for this entry. No other characters allowed.

Parent Name

First Name

Last Name

Cell Phone

Note: Please only use numbers for this entry. No other characters allowed.

Parent Name

First Name

Last Name

Cell Phone

(###)

###

####

Other Emergency Contact

First Name

Last Name

Emergency Contact's Phone Number

Note: Please only use numbers for this entry. No other characters allowed.

Doctor's Name

First Name

Last Name

Doctor's Phone Number

Note: Please only use numbers for this entry. No other characters allowed.

Allergies

Please list any allergies your child may have.

Further information will be provided upon registration. Please email Joey Hargrove (joeydh@aol.com) with any questions.

ART CAMP REGISTRATION

August 12-16. 9am - 12noon

Suggested Donation $300 (covers all materials and supplies)

ages 4-6

Child's Name

First Name

Last Name

Child's Age

Child's Birthdate

MM

DD

YYYY

Grade

Please indicate child's grade level and school.

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Home Phone

Note: Please only use numbers for this entry. No other characters allowed.

Parent Name

First Name

Last Name

Cell Phone

Note: Please only use numbers for this entry. No other characters allowed.

Parent Name

First Name

Last Name

Cell Phone

(###)

###

####

Other Emergency Contact

First Name

Last Name

Emergency Contact's Phone Number

Note: Please only use numbers for this entry. No other characters allowed.

Doctor's Name

First Name

Last Name

Doctor's Phone Number

Note: Please only use numbers for this entry. No other characters allowed.

Allergies

Please list any allergies your child may have.

Further information will be provided upon registration. Please email Joey Hargrove (joeydh@aol.com) with any questions.

We Are United

The People of the United Methodist Church

We Are United

The People of the United Methodist Church

Pastor Wayne’s Farewell Luncheon - June 9

YOUTH THEATRE CAMP REGISTRATION

ART CAMP REGISTRATION

We Are United

We Are United

Welcome Home

Welcome Home

You Are Loved

You Are Loved