Please complete all the information below and be sure to hit the 'submit form' button at the bottom.
Thank you.
Date:
Name:
Address: City: State: Zip:
Phone: E-Mail:
Birthdate: Anniversary:
Church Home:
I will be attending the Daytime Eveningsession. (Night time attendees may leave the rest of the form blank...don't forget to hit 'submit form.')
Because our KIDS Life programs (nursery-8th grade) are provided by volunteers, we ask that every woman serve two times per year. I would like to help (please check two):
Sep. 14 Sep. 28 Oct. 12 Oct. 26 Nov. 9 Jan. 25
Feb. 8 Feb. 22 Mar. 14 Mar. 28 Apr. 11 Apr. 25
I am also willing to be called as a substitute when needed:
Please indicate first (1) and second choice (2) of Titus Moms. Please note that group size is limited and we will do our best to place you where you request! We will place you in a group if you prefer to leave blank.
Cassandra Deans Michele Norman Tommie Clemmer
Lin Jaecks Nancy Gay Cathy Gaffney
Marlit Stansell (moms & little ones) Mary Beth Griz (High School/College Age Women)
Audrey Broggi ("20 somethings")
Please list your children who will be attending KIDS Life (birth and up)
NAME DOB GRADE M/F SPECIAL NEEDS/ALLERGIES Class Choice
9:45-11 11-12:15
In the "Class Choice" columns please select one of the following options based on your child's grade:
9:45 - 11:00 5th-8th grade: Presidential/Health = PH OR Art = A
2nd-4th grade: Science = SC OR Geography/Missions = GM
11:00 - 12:15 5th-8th grade: Science = SC OR Writing = W
1st-4th grade: Presidential/Health PH
2nd-4th grade: Art = A
**********PRESIDENTIAL PARTICIPANTS MUST ALSO FILL OUT GREEN FORM*************
I understand that this is not a drop off program and am required to be on campus at all times while my children are here.
Please print your name to acknowledge: