Adventurer Registration Form

Home
Ministries
Madison Doves Adventurer Club
Adventurer Registration
Adventurer Registration Form

Email
Print
Facebook
Twitter

Child's Name

Age

DOB

Address

T-Shirt Size

Grade Level

Parent/Legal Guardian 1 Name

Parent/Legal Guardian 1 Phone

Parent/Legal Guardian 1Email

Parent/Legal Guardian 2 Name

Parent/Legal Guardian 2 Phone

Parent/Legal Guardian 2 Email

Address (If different from above.)

Emergency Contact Name

Phone

Family Physician

Phone

Medical Insurance Provider

Drug Allergies (If none, type 'None')

Other Allergies (If none, type 'None')

Medications (If none, type 'None')

Conditions that would impact participation in activities (If none, type 'None')

Accomodations needed for my child to participate in activities (If none, type 'None')

Musical Talents and/or Spiritual Gifts

Would you be willing to travel to Birmingham, Nashville or Chattanooga for a special outing?

Yes No

What trips would your child be most interested in taking part as a member of the club? (Pick all that apply.) Chattanooga Zoo Discovery Center Birmingham Zoo McWane Science Center US Space and Rocket Center Skating Rink Adventure Science Center Nashville Other

If you chose other, what venue(s) do you suggest?

YouTube

Grace Fellowship SDA Church

710 Nance Rd, Madison, AL 35757-7807

Legal Notice & Privacy Policy
Provided by the North American Division and AdventistChurchConnect.org © 2002-2024. Sitemap. User Login / Customize