Father - First Name:      Last Name:
Address:  City:    Zip:
Email:
Home Phone:      Cell Phone:

Mother - First Name:      Last Name:
Same address as Father
Address:  City:    Zip:
Email:
Home Phone:      Cell Phone:

If parents cannot be reached, emergency contact:        Phone:  

Names of alternate people (up to four) that can pick up your child (must be in 7th grade or older). The child(ren) will ONLY be released to the authorized alternative people listed on this registration form:

Parents make the difference traiining their child up in the Lord! I prefer to help:
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