2021-2022 Adventure Island Registration

Please fill out this form to register, or return a hard copy to:

Faith Reformed Church
243 S. 4th St.
Cedar Grove, WI 53013

Links:

Informational Letter
Calendar
Application (Hard Copy)

Parent/Guardian Info

Parent/Guardian Name(s)

*

Relationship to Child(ren)

*

Family Address

*

Phone Number

*

Email Address

*

This address will receive a confirmation email

Emergency Contact

*

Emergency Contact - Phone

*

*By registering your child(ren) for Adventure Island, you grant permission for Faith Reformed Church to use multimedia recorded at various activities in church-related materials. Some multimedia may include images of your child(ren), so you may opt-out by checking this box:

Please select all that apply.

Opt-out

Student Info

Child #1 Name

*

Child #1 Birthday

*

Child #1 Grade

*

Please select one option.

5K 1st 2nd 3rd 4th 5th

Child #1 Special Instructions/Allergies

Child #2 Name

Child #2 Birthday

Child #2 Grade

Please select one option.

5K 1st 2nd 3rd 4th 5th

Child #2 Special Instructions/Allergies

Child #3 Name

Child #3 Birthday

Child #3 Grade

Please select one option.

5K 1st 2nd 3rd 4th 5th

Child #3 Special Instructions/Allergies

Child #4 Name

Child #4 Birthday

Child #4 Grade

Please select one option.

5K 1st 2nd 3rd 4th 5th

Child #4 Special Instructions/Allergies

Description

Please fill out this form to register, or return a hard copy to:

Faith Reformed Church
243 S. 4th St.
Cedar Grove, WI 53013

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