Christmas Play Registration

A SUPER CHRISTMAS - Online registration Form

Child's Name *

First

Last

Child's Age *

Child's Food Allergies *

Emergency Contact Name *

First

Last

Relationship *

Emergency Contact Phone Number *

Does your child need a costume? *

Yes No

If yes, what size costume is your child? *

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? *

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. *

I agree

Name of Individual Giving Permission *

First

Last

Phone Number *

Submit