Christmas Party Registration - JB Blayton - Wednesday December 13

Step 1 of 2: Submit

Please complete all items; the red asterisk items are required.

Child Information

Gender: *
Grade Level: *
Is a Parent in the military? *
Does your child attend a church?

Parent/Guardian Information

If the parent/guardian is not reachable, the following additional adults are authorized contacts for emergencies and pick-up after club.

Select how your child will get home after the party. *

Parent/Guardian Permission and Agreements

Indicate your permission/agreement by checking all that apply:

To confirm your permission and above agreements, click in the box to enter your signature. Disregard "use your camera" and select the "sign with your mouse or trackpad" link option so sign using the cursor.

Date: Thursday, 19 April 2018 (EDT)
Type your name to sign this document:
Typing name is equivalent to a handwritten signature

* indicates required fields