2019-2020 Sunday Night BLAST Registration

Sundays September 15 -May 3, 5:30-7PM | 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:

Parent/Guardian's Name

*

Address

*

Cell Phone

*

Email

*

This address will receive a confirmation email

Emergency Contact Name

*

Emergency Contact Phone

*

Other adults my child may go home with:

Allergies/Medical Concerns

T-Shirt Size

*

Please select one option.

Small Medium Large Adult Small

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

*

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 15 -May 3, 5:30-7PM

Please complete this form and submit! Thank you!

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