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Registracion del Participante

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Northside Church

Location

2571 N Highland Ave

Jackson, TN 38305

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Contact Miranda Goldsby:

731-554-0805

miranda@northsidejackson.com

Primero, cuéntenos sobre usted:

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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País

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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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Teléfono del Contacto de Emergencia

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Nombre de recogida alternativo

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Teléfono de recogida alternativa

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Afiliación de la iglesia local

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How many will attend the FAMILY Night on Friday night? (Dinner provided)

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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.

Cuéntanos sobre tu participante

NOTE: Child must have been 3 years old by August 15, 2025, in order to register for Pre School.

Preschool Class: Child will be eligible for Kindergarten in the Fall of 2027.

Pre-K Class: Child will be eligible for Kindergarten in the Fall of 2026.

*When choosing grade, please select the grade your child just COMPLETED (2025-2026 school year)

**PLEASE NOTE: Nursery will only be provided for children of VBS Volunteers.

Nombre

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Apellido

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Grado Saliendo

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Género

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Fecha de nacimiento

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Medical Release-Do you grant permission for any medical or surgical treatment which may be necessary in your absence for the well-being of your child?

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Photo/Media Release-Does Northside Church have permission to use pictures/videos of your child for promotional materials, such as as videos, social media posts, brochures, etc?

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Allergies/Medical Concerns:

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