Highrock Church > Events

Child's Name *

Child's Birthday *

Parent/Guardian Name(s) *

Email (Best email to send important information regarding Summer Blast) *

Mailing Address (Will only be used to follow up with a postcard from your child's crew leader) *

Parent/Guardian phone number (A number where a parent/guardian can be reached while child is at Summer Blast) *

Emergency Contact (Include name and phone number)

Allergies/Medical Conditions (Please inform us of all food allergies or other medical conditions we need to know about. Please also include if your child will be bringing an EPI pen.)

Alternate Pick up (Please list the name(s) of any other adults that may be picking up your children from Summer Blast, if not the parent/guardian listed above.)

Scholarship needed? *

Additional Notes

Highrock Church

June 29, 2012

Highrock Kids! Summer Blast: SKY!

Summer Blast! Registration

Summer Blast Volunteer Sign-up