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Corry Christian & Missionary Alliance Church

Location

721 Hatch Street

Corry, PA 16407

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Contact Kevin Wilkinson:

814-964-1516

wilkinsonkevin40@gmail.com

First, Tell Us About Yourself:

Parent Information

Corry Christian & Missionary Alliance Church SCUBA VBS 2024

****By filling out and turning in this form, you're acknowledging and consenting to the possibility of your child being photographed for promotional purposes. Which may include social media, but the main purpose is to have a slideshow after each night and show our Church congregation during our church services which are live streamed.

First Name

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Last Name

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Address 1

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City

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State/Province

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Contact Phone 1

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Contact Phone 2

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Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Tell Us About Your Participant

First Name

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Last Name

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Grade Leaving

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Gender

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Date Of Birth

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Allergies

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Do you have friends you would like to be placed with? We will do our best to group selected friends together in the same crew, but we cannot promise all requests will be possible.

Friend 1 First Name

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Friend 1 Last Name

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Friend 2 First Name

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Friend 2 Last Name

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Medical Concerns

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Comments

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