Destination Dig Registration Form

Please fill out this form and click submit.

Child's Name

*

Birth date

*

Previous Grade/Current Age

*

Please select one option.

1 year old 2 years old 3 years old 4 years old 5 years old Kindergarten First Grade Second Grade Third Grade Fourth Grade Fifth Grade

Parents Name/s

*

Parent Email

*

This address will receive a confirmation email

Contact Phone

*

Address

*

Medical Information/Allergies

*

Emergency Contact (Other than listed above) Names & Phone Numbers

*

Who may pick up your child

*

Does your child attend church on Sundays or Wednesdays somewhere else?

*

Can your child be photographed for promotion purposes

*

Please select all that apply.

Yes No

Description

Please fill out this form and click submit.

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