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Party in the Park

4 Night Summer Kids Program

Registration Form

Child's Full Name

Current School Grade

Gender

Male

Female

Alberta Health #

Date of Birth

Allergies/Conditions

Parent/Guardian Full Name

Home Phone

Address

Parent Cell Phone

Town

Email Address

Child's Age

What dates will your Child be attending? August 21/22/23/24

Dates attending

Do you currently attend a church? If so where?

Church

Emergency Contact Info

Please list two people we can contact if you cannot be reached

# 1 Full Name

#2 Full Name

# 1 Relation

#2 Relation

# 1 Emergency Contact

#2 Emergency Contact

Please ensure that you read the Consent & Waiver document & then click the box to acknowledge you've done so.View Consent & Waiver Document

Thanks for signing your child up to Party in the Park 2023

Lakeview Gospel Centre

4801 54 Street
Bonnyville, AB
T9N 1Z1

780-826-5150
info@lakeviewgospel.ca

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