S.M.A.K. - Summer Music Activities for Kids

Online Registration Form

 

Registering for S.M.A.K. is easy with our online registration form. Simply fill in the form below and click "Submit Registration Form ". Please make sure that all information is correct prior to submitting forms. Only one form is required per family. Form fields with and asterisk (*) are required. Please accompany children to the check in desk on the first morning as a signature from a parent or legal guardian will be required to complete the registration.

Thank you for your cooperation.

Northside Baptist
S.M.A.K. Registration Form
Aug. 3-7, 2009 / Ages 4 yrs-6th Grade/8:45am-12- Final Musical Aug 7th @7pm
1st Child

Name (*):

Age(*): Grade going into(*):


Past Experience:

Allergies:
2nd Child

Name:

Age: Grade going into:

 

Past Experience:

Allergies:
3rd Child

Name:

Age: Grade going into:

 

Past Experience:

Allergies:
4th Child

Name:

Age: Grade going into:

 

Past Experience:

Allergies:
Parent/Guardian Information

1st Parent Name(*):

2nd Parent Name:

Address(*):

City(*):

Zip(*):

Home Church (if applicable):

Home Phone(*):

Cell Phone:

Email(*):

Emergency Contact Name(*):

Emergency Contact Phone(*):

Who will pick your child(ren) up at the end of each day?(*):

Comments/Questions:
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Northside Baptist Church - 7965 Oswego Rd. - Liverpool, NY 13090 - (315) 652.3160
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