Summertime Spectacular Registration Form

Child's Name:

Address:

Phone:

Parent’s Name:

Emergency contact:

Parent’s cell phone:

Parent’s email:

Does your child have a food allergy or any special needs that we need to be aware of?

I, give my permission for my child to participate in the Summertime Spectacular at Mt. Zion Baptist Church.

Signature (Initial to indicate e-signature):