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Please fill out the form below to register your child/children for High Seas Expedition.  We can't wait to see you there! 
July 19-23, 2010 (9am - noon)

Child's Full Name:        Male     Female
Birth Date (mm/dd/yyyy):  
Grade completed as of June 2010:   
  My chid would like to be grouped with a friend.    
Friend's Name(s):
 
Mother's Name:            Phone:  
                                                                                            Email:  
Father's Name:             Phone:  
                                                                                            Email:  
Emergency contact:      
Emergency phone:    
Special Needs/Allergies/Medications (if "none", please indicate):

How did you find out about High Seas Exoedition?
  Friend          Sign Outside         Church       Other   
Mailing Address (please include ZIP code):
 
 

Please list additional children in the same family below (if no additional children, please scroll to bottom):

2nd Child's Full Name:        Male   Female
Birth Date (mm/dd/yyyy):  Grade completed as of June 2010:   
  My chid would like to be grouped with a friend.    

Friend's Name(s) :   

Special Needs/Allergies/Medications (if "none", please indicate):

 
 

3rd Child's Full Name:        Male   Female
Birth Date (mm/dd/yyyy):  Grade completed as of June 2010:   
  My chid would like to be grouped with a friend.    

Friend's Name(s) :   

Special Needs/Allergies/Medications (if "none", please indicate):

4th Child's Full Name:        Male   Female
Birth Date (mm/dd/yyyy):  Grade completed as of June 2010:   
  My chid would like to be grouped with a friend.    

Friend's Name(s) :   

Special Needs/Allergies/Medications (if "none", please indicate):

 
 

               
                Join us for worship at
             9:30, 11am, & 5pm!
           CLICK HERE for directions!