Pancakes w/Santa & Parents Morning Out

Registration Form

Forms of payment include: CHECK, CASH OR ONLINE (AND KIOSKS)

Child's Name

First Name

Last Name

Age

Date of Birth

Current Grade

Parent/Guardian Name(s)

First Name

Last Name

Parent/Guardian Name(s)

First Name

Last Name

Phone

(###)

###

####

Email

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact/Phone (other than parent)

Allergies/Medical concerns/Needs

I AGREE

By registering my child, I give permission for full participation in all activities at Pancakes with Santa and permission for Broadmoor UMC to post photos on church sponsored website and/or social media. CLICK AGREE to serve as Signature of parent/guardian.

AGREE

Pancakes w/Santa & Parents Morning Out

Registration Form

Inspire people to KNOW, GROW & GO in God’s love!