Last Name:*
Child's First Name:*
Birthday*
Child's age on Sept. 1, 2024*
T-shirt Size*
Allergies
If allergic, child will have epi-pen.

 
Parent/Guardian Name*
E-mail Address:*
Phone Number*
Choose One*
 
2nd Contact's Name*
2nd Contact's Phone*
 
I hereby give Suncreek UMC authorization to have my child treated in the event of a Medical Emergency.
 
I acknowledge that photos/video of my child may be displayed on the church website and social media.
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