AMHERST CHURCH OF THE NAZARENE
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A SUPER CHRISTMAS - Online registration Form
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Indicates required field
Child's Name
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First
Last
Child's Age
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5
6
7
8
9
10
11
12
Child's Food Allergies
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Emergency Contact Name
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First
Last
Relationship
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Emergency Contact Phone Number
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Does your child need a costume?
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Yes
No
If yes, what size costume is your child?
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XS
S
M
L
XL
Other
Do you give permission for pictures or video taken of your child as part of a group or as an individual to be placed on the Amherst Naz website?
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I DO give permission
I DO NOT give permission
By selecting below, you are agreeing that you have the right to give permission for the child named above. A phone call may be placed to the phone number given in order to verify the permission given on this form.
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I agree
Name of Individual Giving Permission
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First
Last
Phone Number
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Submit
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