Christ Making All Things New

Registration

Family Clay Night

Bring the whole family to a fun night of creating with clay! Your finished creations will be on display at the Budding Artists art show on April 8th at 7pm.

Where: Knowlton Presbyterian Church (3 Knowlton Road, Columbia, New Jersey)
Date: Friday, March 15
Time: 6:00 - 8:00 pm

Family Clay Night

Attendee(s) Information

Attendee 1

First Name

Last Name

Attendee 1 Birth Date

**No age limit for those with special needs.

YYYY

Attendee 1 Last Grade Completed

Attendee 1 Gender

Male

Female

Attendee 2

First Name

Last Name

Attendee 2 Last Grade Completed

Attendee 2 Birth Date

**No age limit for those with special needs.

YYYY

Attendee 2 Gender

Male

Female

Attendee 3

First Name

Last Name

Attendee 3 Birth Date

**No age limit for those with special needs.

YYYY

Attendee 3 Last Grade Completed

Attendee 3 Gender

Male

Female

Special medical needs or medication

Please list any special medical needs for any of your registered children or medication that must carry with them. Also list any food allergies your any of your registered children.

Contact Information

Parent or Guardian's Name

First Name

Last Name

Home Address

Phone Number (best number to contact you in case of emergencies)

(###)

###

####

Home phone (if different from above)

(###)

###

####

Email Address

Permissions

Photograph Permissions

I give permission for photographs of my child to appear in the slide show for this event and in future promotion of similar events.

Yes

List people who will be dropping off or picking up your child

Signature

If this form is filled out electronically, please type your name. Note that we will require a parent or guardian's signature the first morning of camp. By signing this document electronically you agree to give Knowlton Presbyterian Church the right to obtain medical treatment for your child in case of an emergency.