2018-2019 Level Up Registration for Non - Members
 
2018-2019 Level Up Registration for Non - Members
Welcome to Level Up for Kinder - 6th Grade!
1st Night of Level Up - Wed, Aug 29 from 6:15 - 7:45 pm Cost is $45 per child - Family max $115
Child's First Name:  * 
Child's Last Name:  * 
Date of Birth:  * 
Age:  * 
Male or Female:  * 
Grade:  * 
Special Needs:
Home Address:  * 
City:  * 
Zip code:  * 
Parent's First Name:  * 
Parent's Last Name:  * 
Cell #:  * 
Name of Emergency Contact (other than listed parent):  * 
Emergency Contact #:  * 
Food Allergies:
Name of home church:
T-shirt size:  * 
Choose payment - each child must be registered separately but you can make the payment for all children on one registration form.  * 
Your Email Address  * 
Total $
 
 
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