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Sparkz Registration

Please complete the form below to register your child today!

Sparkz Registration

Name of Child*
First Last
Date of Birth*
MM slash DD slash YYYY
Grade (Current School Year)*
Parent/Guardian Name*
First Last
Parent/Guardian Name
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Email*
Will your child be utilizing any of the follow pre-event options?
Check all that apply
- Select All
- Pre-Event Homework Help
- Pre-Event Recreation
- Pre-Event Dinner
Please list the names of all persons authorized to pick up your child from Fellowship Kids' Activities
Does your child have any allergies?
- Select All
- Peanuts
- Nuts (other than peanut)
- Animals
- Wheat
- Dairy
- Soy
- Material (please list below)
- Other (please list below)
Other allergies
Medical Conditions/Restrictions?
I give permission for Fellowship Church to use any pictures which may include my child to promote Kids' Ministry*
- Yes
- No
All church photographers have been authorized by Fellowship Church staff and have obtained the appropriate State-required clearances.
Parent/Guardian E-Signature*

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Every Sunday at 10:30

Fellowship Church
45 Hildebrandt Rd
Dallas, PA 18612

@ [email protected]

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