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Hope Community Church

Location

240 Reed Street

Willow Grove, PA 19090

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Contact Jeremy Cox:

870-834-6483

jeremy@hccwg.org

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Información de los Padres

Nombre

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Apellido

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Correo Electrónico

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Dirección 1

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Dirección 2

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Ciudad

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Estado/Provincia

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ZIP/Código Postal

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Teléfono de Contacto 1

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Teléfono de Contacto 2

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Nombre del Contacto de Emergencia

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Relación del Contacto de Emergencia

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Teléfono del Contacto de Emergencia

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Cuéntanos sobre tu participante

Nombre

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Apellido

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Grado Entrando

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Género

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Fecha de nacimiento

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Alergias

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Preocupaciones Médicas

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¿Tienes amigos con los que te gustaría estar juntos? Haremos todo lo posible para juntar a los amigos seleccionados en el mismo grupo, pero no podemos prometer que todas las solicitudes serán posibles.

Amigo 1 Nombre

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Amigo 1 Apellido

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Amigo 2 Nombre

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Amigo 2 Apellido

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Amigo 3 Nombre

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Amigo 3 Apellido

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Photo Release

I give permission for photos & videos of my child(ren) listed above to be used in Hope Community Church's promotional and LIVE content where his or her face is seen. Examples of this include but are not limited to social media, slide shows, public live stream.

Please Answer Yes or No

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Please type your full name in the box below as your written signature of the above Photo Release.

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Comentarios

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