Laurel Lane Elementary 2019 Christmas Party

Registration for Laurel Lane Christmas Party Club

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Christmas Party - Laurel Lane

Time: After school from 4:05 to 5:15pm
Date: Wednesday December 13th 2023
Place: Laurel Lane Elementary Media Center
Who can attend? All boys and girls in grades K-5, regardless of religious
background. Parents are welcome to attend with their child anytime.
Sponsored by: Williamsburg Community Chapel & CEF of Virginia
Contact for Information: Peg Monahan; mamonahan88@gmail.com or text “PARTY” to 757-968-8161

Note: Our school’s Good News Club is planning to continue next semester.

Child Name *

Birthday - (e.g.; 10/23/2019) *

Age *

Gender *

Male

Female

School *

Grade Level (K, 1, 2, 3, 4, 5) *

Teacher *

Child Allergies *

Yes

No

If yes, please list allergies (peanuts, chocolate, etc.)

Is parent in military? *

Yes

No

Does your child attend church?

Yes

No

Name of church attending

Parent/Guardian Name #1 *

Parent/Guardian Phone #1 *

Parent/Guardian Email #1 *

Parent/Guardian Name #2 *

Parent/Guardian Phone #2 *

Parent/Guardian Email #2 *

Address *

Address

Address

Address

City

City

State/Province

State/Province

Zip/Postal

Zip/Postal

Select how your child will get home on club day. *

My child will be picked up

My child will transition to the school’s extended day/after-school program.

These people (include phone numbers) are allowed to pick up my child if I’m not able to:

Name *

Phone Number *

Name

Phone Number

I give permission for the above named child to attend the Christmas Party at school on Wednesday, December 13 *

Yes

I understand it is my responsibility to pick up my child immediately when the club ends. *

Yes

I will send a note to the school requesting my child stay after school to attend the Christmas Party. *

Yes

I give permission for photographs/videos of my child to be used in club and ministry promotions.

Yes

I give permission for my child to continue attending the GNC after the Christmas Party; when the GNC resumes in 2023.

Yes

I give the above named child to contact me about helping with the Christmas Party.

Yes

Parent/Guardian Signature: Enter your signature in the box using your finger on the touch-pad/track-pad or with your mouse's cursor in the box. *

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Date

Reference Number

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