Calvary Kids Club

Join us Every Wednesday
Time: 1:00 PM – 2:30 PM
Dates: August 27th – October 1st
Please check Peachjar for details

At: Ocotillo classroom A212
Students: K – 6th Grade

Sponsored by: Calvary Chapel Central (602) 336-4555
Contact Lisa Smith at lisasmith@calvarycentral.org

↓ Register below ↓

Click here for video and club theme song.

Students Name:

First

Last

Date of Birth

Grade:

School:

Ocotillo Elementary

Parent or Guardian

Phone:

to video, Concerns/Known

Email:

Address

Address Line 1

Address Line 2

City

State

Zip Code

Emergency Contact Name:

Emergency Contact Phone:

Relationship

After the Club (Please select one):

I will pick up my child
My child has permission to bike/walk
Have my child return to after school program

Other option:

Other Adults Authorized to pick up my child:

(Parents/Guardians are respsonible for their child’s safety from the time the child leaves the school/park until the child reaches home.)

Health Concerns/Known Allergies of my child:

List or put none.

I give permission for images of my child to be captured during Calvary Kids Club through video, photo and/or digital camera, to be used solely for the purposes of promotional material and publications.

No. I do not.
Yes, I do.

Parental/Guardian Permission & Agreement

I agree and give my permission

By completing this form, you are granting permission for your student to attend Calvary Kids Club.