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Participant Registration

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church of Christ at McDermott Road

Location

3600 McDermott Rd

Plano, TX 75025

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Contact Tiffany Ford:

817-946-4722

tiffany@ccmcdermott.org

First, Tell Us About Yourself:

Parent Information

First Name

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Last Name

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Address 1

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City

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ZIP/Postal Code

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Contact Phone 1

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Emergency Contact Name

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Emergency Contact Phone

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Alternate Pickup Name

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Alternate Pickup Phone

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Home Church Affiliation

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Comments

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Are you a visitor?

Multiple selections are allowed.

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If visiting with a friend, please share their name(s.)

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How did you hear about our Kids' Bible Adventure?

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Tell Us About Your Participant

First Name

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Last Name

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Grade Entering

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Gender

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Date Of Birth

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Allergies

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Medical Concerns

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Is there anything we should know about your child?

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Comments

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