EmailMe Form - Urban Adventures Registration 2020

Urban Adventures Registration 2020

This online form will reserve your spot in Urban Adventures
July 20 to July 24, 2020

Please make payments online or contact the church office.

Half Day (9:00am -12:00pm) $20/week (each additional child $5)

Parent Name *
First Last
Parent Name
First Last
Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region
Email *
Home Phone *
### - ### - ####
Cell Phone
### - ### - ####
Emergency *
### - ### - ####
Child *
First Last
Grade Entering Sept 2020 *
Birth Date *
MM / DD / YYYY
Care Card # *
How did you hear about Us? *
Attended Before
Attended Central
Kids in Victoria
Quadra Village Day
Mustard Seed
Neighbourhood Market
Friend Invite
George Jay School
Poster
Other
Date Time *
MM / DD / YYYY

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