Registration for GLOW KIDS - Wednesday Night Program

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The Salvation Army Bowmanville GLOW KIDS Registration Form- Wednesday Night Kids!

Wednesday evening kids' program for ages 6-12 years, every Wednesday night from 6:30 PM - 8:00 PM starting April 3rd. Music, Bible lessons, games, dance, sports, arts, crafts, snacks and more!

Child Information

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Selected Value: 1

Child 1 Name *

First

Last

Child 1 Age

Child 1 Date of Birth *

Parent/Guardian Information (emergancy contact)

Name *

First

Last

Email *

Confirm Email

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Please list details of Allergies and Medical Concerns or "NONE" *

Disclaimer

All physical activities have risks. I agree to allow my child to participate in this event knowing there are physical risks and hazards inherent in any activity.

I voluntarily agree to allow my child to participate in this program. By voluntarily allowing participation, I agree that I am exposing my child to inherent risks and hazards. By signing below, I agree to accept all risks and hazards and be responsible for any injury or other loss which may occur during the participation of my child. I also authorize The Salvation Army to seek emergency medical treatment for my child in the event of injury.

Signature (draw with with cursor or finger) *

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Date

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Child Information

Parent/Guardian Information (emergancy contact)

Disclaimer

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The Salvation Army Bowmanville Community Church

The Salvation Army Bowmanville Food Bank
Tammie Vanderduim – Community Ministries Coordinator

The Salvation Army Bowmanville Thrift Store
Judy Sudsbury – Manager