2020-2021 Sunday Night BLAST!

Sundays September 20 - May 2, 5:30-6:30PM | Please complete this form and submit! Thank you!

Child's Name

Birthdate

Curent school grade:

Please select one option.

pre-k Kindergarten 1st 2nd 3rd 4th 5th

School child attends:

Additional Child(ren): please list name, birthdate and current school grade

Parent/Guardian's Name

Address

Cell Phone

This address will receive a confirmation email

Emergency Contact Name

Emergency Contact Phone

Other adults my child may go home with:

Allergies/Medical Concerns

Does TCBC have permission to use photos/videos of my child for promotional purposes?

Please select all that apply.

Yes No

Do you agree not to hold TCBC liable if your child contracts COVID-19, understanding that there will be some risk in attending?

Please select all that apply.

Yes No

Do you authorize staff/volunteers of TCBC to treat or seek medical treatment in the event of an emergency?

Please select all that apply.

Yes No

Please let us know how you heard about the BLAST program.

Please select one option.

Social Media Flyer in child's school Friend/Family member Attended VBS this summer Attended BLAST last year I am a TCBC member Banner Other

Do you/your family currently have a church home?

Please select all that apply.

Yes No

If so, please share with us where you attend church:

Description

Sundays September 20 - May 2, 5:30-6:30PM

Please complete this form and submit! Thank you!