Preacher's Day Out
Registration Form

Child's Name
Child's Age
City
Address
Grade Going Into
State
In Case of Emergency
Allergies
Insurance Company & Policy Number
I do hereby give my permission for my child to attend 2018 Crossroads Chapel's Preacher's Day Out events.
Name
Date
Submit
Preacher's Day Out activities are for children kindergarten through 5th grade.  Younger children may attend when accompanied by a parent.