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Registracion del Participante

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Parkway Place Baptist Church

Location

300 Parkway Place Drive

Little Rock, AR 72211

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Contact Stephanie Habenicht:

501-224-3003

stephanie@parkwayplace.church

Primero, cuéntenos sobre usted:

Información de los Padres

Please note this first form is for Parent information. You will be able to register more than one child.

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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Mensaje de texto Teléfono

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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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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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Comentarios

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Are you registering a nursery or preschool aged child? Please note that if you answer YES you are also agreeing to have and adult on site during VBS.

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Photography Release: By checking YES you give Parkway Place Church permission to post photos of your child on our website and social media accounts.

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Please list the names of any children that you are registering that are foster children.

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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

Please give us as much information as possible on each child. This helps us best serve them while they are with us.

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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Talla de Camisa

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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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Comentarios

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Help us get to know your child better. Please check any box that describes your child:

Multiple selections are allowed.

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Please add any details to descriptions you checked on the previous question here.

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