"*" indicates required fields URLThis field is for validation purposes and should be left unchanged.Child’s name First Last AgeParent or Guardian's name First Last Contact numberEmail address* Any known allergies*Any known special behavioral needs*Any siblings that are also in attendance*Any special information that you would like for us to know so that we can better interact with your child?*Bus Pickup and Drop off? If so, please provide the address for the child. Please note that we are only able to pick up/ drop off with-in 10 miles of the church. This area includes the Talmo/ Pendergrass area and most of Maysville.Parent Pickup and Drop off? Please provide the authorized adult(s) allowed to pick up.CAPTCHA Δ
