Destination Dig 2021

Participant Registration

If you or your child would like to participate in this event as a Participant, please complete the following form.

(If you are under 18, please have your parent or guardian complete the form.)

If you have previously registered with us for a prior event, you can search for your stored information instead of filling out the form below.

Personal Information

*Participant's First Name:
*Participant's Last Name:
*Parent/Guardian Name:
*Address:
*City:
*State:
*Zip:
*Home Phone: (555-555-5555)
Work Phone: (555-555-5555)
*Cell Phone: (555-555-5555)
*Email:
*Birthday: (MM/DD/YYYY)
*Pick a grade: (Grade for Fall, 2021)
*Is your child allergic to hand sanitizer?:	Yes No
Allergies, Medical, & Special Needs: (Leave Blank if None)
*Permission to Treat: (Appropriate first aid)
*I am the/a parent and/or legal guardian of the child I am enrolling. I understand it is my responsibility to notify the classroom leaders as to where I can be reached in the event of an emergency.
Important information you think we should know about your child:
*Emergency Contact Name (1):
*Emergency Contact Phone (1): (555-555-5555)
*Emergency Contact Name (2):
*Emergency Contact Phone (2): (555-555-5555)
Custody Concerns?: (If yes, list the concerns here and notify class leaders or Director.)
*Authorized Pickup #1:
Authorized Pickup #2:
Authorized Pickup #3:
Authorized Pickup #4:
*Does your child need a ride?:	Yes No
Are you a member of this church?	Yes
Guest of:
Do you attend Church?	Yes
If so, where?
May we have permission to photograph your child?	Yes
May we have permission to use your child's photograph in church publications?	Yes
Select a t-shirt size: (T-Shirt Size:)
Comments:
Gender: