Summer Spectacular Signup

Your child’s Name :
Child’s Birthdate : ex. 8/10/2001
Child’s Grade in September:
Gender : Male
Female
Address
City
State
Zip
Home Phone
Cell Phone
Emergency Phone
Parent e-mail
Parent’s Names
Does your child have any health or food allergies?
 
Does your child have any specific learning needs?
 

   
Photo Release  
I authorize Torrey Pines Christian Church, at it’s sole discretion, to use and publish for any lawful purpose and without compensation, photographs, video, audio and/or depictions of the above named child attending the above event. This authorization shall remain in effect until revoked in writing.
Digital Signature (Please type your DOB ex. 10/8/1970)
   
Authentication Code