CARAVAN

Caravan Registration

Please complete the form below and click the Submit Button at the bottom of the page to register your children for Caravan. Please include your email address if you would like to receive a verification from the church office.

Child's Name (required)

Child's Age (required)

Child's Grade that was completed

Child's date of birth (required)

Special instructions or information (food or drug allergies, asthma or any other medical or emotional conditions) we should know about.

Child's Name

Child's Age

Child's Grade that was completed

Child's date of birth

Special instructions or information (food or drug allergies, asthma or any other medical or emotional conditions) we should know about.

Child's Name

Child's Age

Child's Grade that was completed

Child's date of birth

Special instructions or information (food or drug allergies, asthma or any other medical or emotional conditions) we should know about.

Child's Name

Child's Age

Child's Grade that was completed

Child's date of birth

Special instructions or information (food or drug allergies, asthma or any other medical or emotional conditions) we should know about.

_________________________________________________________________________________________________

Parent/Guardian Name (required)

Home Address (required)

Phone Number

Alternate Phone Number

Email Address

Emergency Contact Name (other than listed above)

Emergency Contact Phone Number

Emergency Contacts relationship to Child

We love carpooling but for your child’s safety, your child will not be allowed to leave with anyone that has not been listed below. List any other adults who have permission to take your child home.

Other Adult

Other Adult

Other Adult

Photograph usage permission for a minor (Select One)
I give permission to the Bangor Church of the Nazarene to use pictures taken of my children for any Promotions of this event.I give permission to the Bangor Church of the Nazarene to use pictures taken of my children ONLY for crafts/projects to be taken home by my children.I do not want my children’s photo used.

If you are interested in other children’s events, what is the best way for us to inform you?
PhoneTextMailE-Mail

If you regularly attend a church, please tell us your Church's Name

By clicking the "Submit" button below, you agree to give permission for your children to participate in Caravans at the Bangor Nazarene Church.