Register for Children’s Summer Program

Parent/Guardian Name:

First Name

Last Name

Email Address:

Phone:

(###)

###

####

Permitted Pick-up:

Who has a permission to pickup your child(ren)? The individual dropping a child off will always be assumed to be allowed to pick the child up.

Child's Name:

Child's Grade:

The grade your child is going into this coming school year.

2nd Child's Name:

2nd Child's Grade:

3rd Child's Name:

3rd Child's Grade:

4th Child's Name:

4th Child's Grade:

5th Child's Name:

5th Child's Grade:

Sibling Information:

Let us know any sibling information as needed. If you have more than 5 children, please submit the form again with additional children.

Other Information:

Anything you think we should know to help your child(ren) have the best time possible.

Allergies:

Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

We respect your privacy and will not publish or share any of this information beyond our use for Oakwood Baptist Church’s Children ministry.