Christmas Kids Morning Out!

Adult name:

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Email

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This address will receive a confirmation email

Family Info

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Foster Adoptive Kinship Guardianship Other

Name of Agency (if applicable)

Phone

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Address

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Please provide the following information for all children that will be attending. Please include your children's FIRST and LAST name. All information is required to register your child in childcare.

Child's full name:

Birthdate: Ex. (00/00/0000)

Grade:

Specific instructions for child:

Child's full name:

Birthdate: Ex. (00/00/0000)

Grade:

Specific instructions for child:

Child's full name:

Birthdate: Ex. (00/00/0000)

Grade:

Specific instructions for child:

Child's full name:

Birthdate: Ex. (00/00/0000)

Grade:

Specific instructions for child:

Child's full name:

Birthdate: Ex. (00/00/0000)

Grade:

Specific instructions for child:

Child's full name:

Birthdate: Ex. (00/00/0000)

Grade:

Specific instructions for child:

Child's full name:

Birthdate: Ex. (00/00/0000)

Grade:

Specific instructions for child:

Permission: I give permission for my child/children to be cared for by Fostering Connections volunteers. Please type YES if you are planning for your kids to attend this event.

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I give permission for my family and/or child(ren) to be photographed. Photos may be used on our social media or our website.

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yes no

Please list any child(ren) in your home who will be attending the event and cannot have their photo taken

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Thank you! We look forward to seeing you there!

Description

Christmas Event/Countryside Christian Church 1901 E. 4th Street Pittsburg, KS Sat., Dec. 5 10:00 am - 12 pm

Please fill out this form and click submit.