Middle School All-Nighter - November 3-4, 2017
Multiple students registering on one form must belong to the same household.
Name of Child #1 Attending:
Name of Child #2 Attending:
Name of Child #3 Attending:
Choose # registering and payment option:
One Student Registration (Add $25.00)
Two Student Registration (Add $50.00)
Three Student Registration (Add $75.00)
I am bringing my payment to the church.
Parents' Contact/Emergency Phone Number
The email address requested below should be the parent's email address.
Your Email Address
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