Event Registration

Child First Name:
Child Last Name:
Birth Month:
Birth Day:
Birth Year:
Grade Completed:
Age:
Parent First Name:
Parent Last Name:
Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Email:
List All People Who Are Allowed to Pick Up Your Child:
Emergency Contact:
Emergency Phone:
Special Needs/Allergies:
Home Church (if any):
I authorize my child's photo to be taken and used for our website use.
How did you hear about this event?

Calvary Bible Church
629 Union School Road, Mount Joy, PA, 17552
Phone:717.653.5857