PARTICIPANT'S NAME (required)

AGE (required)
34567891011

GRADE (required)
3K4K5K1st Grade2nd Grade3rd Grade4th Grade5th Grade

SEX (required)
MaleFemale

PARENT/GUARDIAN NAME (required)

PHONE NUMBER (required)

EMAIL (required)

STREET ADDRESS (required)

CITY (required)

STATE (required)

ZIP (required)

MEDICAL INFORMATION (such as allergies) (required)

Name of person who will be bringing and picking up child (if other than parent/guardian)

Relationship to Child

Phone Number

I would like to be contacted about future events at Garden City Baptist Church (required)
YesNo

Permission for my child to be photographed during this event? (required)
YesNo

Permission to use my child's photograph and/or likeness for the purpose of promotion? (required)
YesNo